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General NPI Number Information
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NPI Number | 1497571764
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Entity Type | Individual
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Provider Name | CELESTE SUZANNE BUCK DC
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Gender | Female
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Dates
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Enumeration Date | 12/02/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 115 E 14TH ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-3220
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Country | US
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Telephone | 231-943-1767
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Fax |
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Provider Business Mailing Address
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Address Line | 1802 E FRONT ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-3019
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Country | US
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Telephone | 231-709-1407
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301401578
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License Number State | MI
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