Most Relevant Information
Provider Data
| NPI Number: | 1003458514 |
| Provider Name: | QUINTON BUCKHANAN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: | 537153 |
Most Important Dates
| Enumeration Date: | 10/16/2019 |
| Last Updated: | 10/16/2019 |
Provider Practice Location
1981 LEWIS TURNER BLVD
FORT WALTON BEACH
FL
325471256
Practice Location Phone/Fax
| Phone: | 8506076910 |
| Fax: | 8506076932 |
Provider Mailing Location
3771 STEFANI RD
CANTONMENT
FL
325337795
Provider Mailing Phone/Fax
| Phone: | 8506076910 |
| Fax: | 8506076932 |