Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1891 | NV |
NPI | 1023058054 |
---|---|
Provider Name | Joan Jarboe Buckler |
First Address | Reno, NV 89521-5011 |
Second Address | Reno, NV 89502-2597 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 12/07/2007 |