Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 11061 | OH |
NPI | 1639582158 |
---|---|
Provider Name | Jennifer E Buckland |
First Address | Euclid, OH 44119-1078 |
Second Address | Euclid, OH 44119-1078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2014 |
Last Update Date | 03/06/2014 |