Krystle Buckner

Individual provider Active NPI Prosthetics Case Management · Columbia, SC

NPI 1831829902 · NPPES record last updated Jun 13, 2022

Key facts

NPI
1831829902
Entity type
Individual (NPI type 1)
Primary specialty
Prosthetics Case Management 1744P3200X
License
34984 (SC)
Practice address
1930 Oak St
Columbia, SC 29204-1025
Phone
(803) 463-1023
NPI assigned
Jun 13, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
34984SCMDProsthetics Case Management

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X 34984 SC Yes

Addresses

Primary practice location

1930 Oak St
Columbia, SC 29204-1025

Mailing address

1930 Oak St
Columbia, SC 29204-1025
Phone (803) 463-1023

Electronic endpoints

TypeEndpointUseAffiliation
Other URL Blackberry Other

Other providers in Columbia, SC

All providers in Columbia, SC · Prosthetics Case Management in South Carolina

Sources for this page

Verify at the official NPI Registry.