MEDICARE: CONNOR ALEXANDER BUCK DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2021015010	MO
2	225100000X	Physical Therapist	P19074	NC

General Provider Information

NPI Number	:	1013562370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CONNOR ALEXANDER BUCK DPT

Provider Business Mailing Address
First Line	:	1991 FORDHAM DR STE 100
Second Line	:
City	:	FAYETTEVILLE
State	:	NC
Zip	:	28304-3774
Country	:	US
Telephone Number	:	910-484-4653
Fax Number	:

Provider Business Practice Location Address
First Line	:	8250 N CHURCH RD STE B
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64158-1103
Country	:	US
Telephone Number	:	910-484-4653
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2019
Last Update Date	:	08/13/2025

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Directions to “ CONNOR ALEXANDER BUCK DPT” Practice Location

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