Basic Information
| Provider Information | |||||||||
| NPI: | 1023058054 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUCKLER | ||||||||
| FirstName: | JOAN | ||||||||
| MiddleName: | JARBOE | ||||||||
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| Credential: | PT | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | JARBOE | ||||||||
| OtherFirstName: | JOAN | ||||||||
| OtherMiddleName: | ELLEN | ||||||||
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| OtherCredential: | PT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1771 CANYON SHADOW CIR | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895215011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752329691 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1000 LOCUST ST | ||||||||
| Address2: | PHYSICAL THERAPY DEPT | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895022597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7757867200 | ||||||||
| FaxNumber: | 7753372260 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 07/12/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251X0800X | 1891 | NV | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No ID Information.