Individual
KEITH ANTONIO BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5973 BENT PINE DR, 2001, ORLANDO, FL 32822-3397
(404) 487-8851
(404) 952-1839
Mailing address
9302 MEADOW CIR, COLLEGE PARK, GA 30349-7826
(404) 487-8851
(404) 952-1839
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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