Jeffrey Bucknam

NPI #1295164846 in Traverse City, Michigan

Provider Information

NPI Number: 1295164846
Entity Type: Individual
Name: Jeffrey Bucknam
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Enumeration Date: Nov 4, 2013
Last Updated: Nov 4, 2013

Practice Location

Address: 7711 GINGERWOOD DR
City: Traverse City
State: Michigan
ZIP Code: 49685-9024
Phone: (231) 715-6122

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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