Individual
EVAN JAMES BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
15810 S 42ND ST, PHOENIX, AZ 85048-7409
(480) 759-0358
Mailing address
273 N CROSSCREEK DR, CHANDLER, AZ 85225-1898
(480) 694-2965
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-010838
AZ
Other
Enumeration date
08/24/2021
Last updated
08/24/2021
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