Individual
MR. ERNEST W BUECHE II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1325 E FORTIFICATION ST, JACKSON, MS 39202-2442
(601) 949-9140
Mailing address
PO BOX 355, GOODMAN, MS 39079-0355
(225) 937-1295
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATO614
MS
Other
Enumeration date
10/05/2012
Last updated
10/05/2012
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