Individual
MR. JODY ALBERT BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.N.A
Contact information
Practice address
1220 SHIRLAND AVE, ALEXANDRIA, LA 71301-7246
(318) 730-7832
Mailing address
1220 SHIRLAND AVE, ALEXANDRIA, LA 71301-7246
(318) 730-7832
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
10636000#P8Q83
LA
Other
Enumeration date
09/29/2015
Last updated
09/29/2015
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