Provider Demographics
NPI:1295913580
Name:BUCKLAND, LINDA ALISON (LMT)
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ALISON
Last Name:BUCKLAND
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 KETCHUM RD
Mailing Address - Street 2:
Mailing Address - City:CONKLIN
Mailing Address - State:NY
Mailing Address - Zip Code:13748
Mailing Address - Country:US
Mailing Address - Phone:607-251-2300
Mailing Address - Fax:
Practice Address - Street 1:3101 SHIPPERS RD
Practice Address - Street 2:SUITE 204
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850
Practice Address - Country:US
Practice Address - Phone:607-251-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-08
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020935225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist