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NPI Code Detail

MEDICARE: KAYLA VANESSA BUCK OTR/L

MEDICARE: KAYLA VANESSA BUCK OTR/L
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
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1770125312
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA VANESSA BUCK OTR/L
Provider Business Mailing Address
First Line : 9600 NUMBER 5 SCHOOL RD NW
Second Line :
City : ASH
State : NC
Zip : 28420-2122
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9600 NUMBER 5 SCHOOL RD NW
Second Line :
City : ASH
State : NC
Zip : 28420-2122
Country : US
Telephone Number : 910-287-6007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2019
Last Update Date : 10/15/2019

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Directions to “ KAYLA VANESSA BUCK OTR/L” Practice Location

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