Individual
WHITNEY RENEE WISE BUCKLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7035 SAINT ANDREWS RD, COLUMBIA, SC 29212-1177
(803) 749-0924
(803) 407-4101
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2078
SC
Other
Enumeration date
03/12/2014
Last updated
10/15/2020
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