Buccille, Justin

Buccille, Justin is an individual health care provider with primary practice located at 918 S Mount Olive St , Siloam Springs AR 72761-4220. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Buccille, Justin can be contacted via phone (479) 967-2322.

Contact Information

Primary practice address
918 S Mount Olive St Siloam Springs AR 72761-4220
Phone: (479) 967-2322
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X

Profile Details

NPI number 1134421720
LBN Legal business name Buccille, Justin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2010
Last updated Apr 2nd, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134421720 NPPES
Arkansas MEDICAID 184894721

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