Provider Demographics
NPI:1699372136
Name:BUCKHOUT, MARIE BEH (DC)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:BEH
Last Name:BUCKHOUT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MISS
Other - First Name:MARIE
Other - Middle Name:FLORENCE
Other - Last Name:BEH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:21 BEMIS STREET
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493
Mailing Address - Country:US
Mailing Address - Phone:860-839-4394
Mailing Address - Fax:
Practice Address - Street 1:517 WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458
Practice Address - Country:US
Practice Address - Phone:617-969-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor