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General NPI Number Information
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NPI Number | 1417838731
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Entity Type | Individual
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Provider Name | REBECCA BUCKNER
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Gender | Female
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Dates
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Enumeration Date | 09/11/2025
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 5930 CORNERSTONE CT W STE 300
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City | SAN DIEGO
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State | CA
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Zip | 92121-3772
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Country | US
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Telephone | 866-687-7390
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Fax |
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Provider Business Mailing Address
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Address Line | 1555 W ALLENS BRIDGE RD
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City | GREENEVILLE
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State | TN
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Zip | 37743-5153
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | CP049325T
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3014
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License Number State | TN
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