MR. Larry R Buckley, PA-C, MPA

NPI #1356330542 in Rolla, Missouri

Provider Information

NPI Number: 1356330542
Entity Type: Individual
Name: MR. Larry R Buckley, PA-C, MPA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C, MPA
Enumeration Date: Oct 19, 2005
Last Updated: Nov 17, 2009

Practice Location

Address: 600 BLUES LAKE PKWY
City: Rolla
State: Missouri
ZIP Code: 65401-8022
Phone: (573) 364-8822

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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