Healthcare Provider Details

I. General information

NPI: 1689865107
Provider Name (Legal Business Name): BUCKLER CHIROPRACTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 08/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42261 SIERRA DR
THREE RIVERS CA
93271-9402
US

IV. Provider business mailing address

PO BOX 296
THREE RIVERS CA
93271-0296
US

V. Phone/Fax

Practice location:
  • Phone: 559-561-2209
  • Fax:
Mailing address:
  • Phone: 559-561-2209
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberDC0019395
License Number StateCA

VIII. Authorized Official

Name: DR. JOHN M. BUCKLER
Title or Position: VICE PRESIDENT
Credential: D.C.
Phone: 559-561-2209