Individual
DR. JOHN EDD BUCKLEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
600 E 5TH ST, FULTON, MO 65251-1753
(573) 592-2796
Mailing address
600 E 5TH ST, FULTON, MO 65251-1753
(573) 592-2796
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00975
MO
Other
Enumeration date
12/07/2007
Last updated
12/07/2007
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