Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath |
NPI | 1245859099 |
---|---|
Provider Name | Kelly A Buchanan |
First Address | Morganton, NC 28655-6714 |
Second Address | Morganton, NC 28655-6714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2020 |
Last Update Date | 12/04/2020 |