Provider Demographics
NPI:1982265971
Name:BUCKLE, LINDA M (PT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:M
Last Name:BUCKLE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 TALBOT BLVD STE W
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-3000
Mailing Address - Country:US
Mailing Address - Phone:410-778-3445
Mailing Address - Fax:
Practice Address - Street 1:201 TALBOT BLVD STE W
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-3000
Practice Address - Country:US
Practice Address - Phone:410-778-3445
Practice Address - Fax:410-778-3702
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21421225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist