Individual ProviderKevin W BueckmanChiropractorChiropractic ProvidersPractice Address653 36th St SW, Wyoming, MI 49509-4004(616) 530-0085(616) 891-5105PECOS EnrollmentBased on the most recent information from CMS, provider Kevin W Bueckman does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1710001896Provider TypeIndividualFull NameBueckman, Kevin WTitleDr.CredentialD.C.GenderMaleSole ProprietorYesEnumeration Date3/16/2007Last Updated7/9/2007Contact InformationPractice LocationPractice Address653 36th St SW, Wyoming, MI 49509-4004Phone(616) 530-0085Fax(616) 531-5029Mailing LocationMailing Address515 North SE, Caledonia, MI 49316-9407Phone(616) 891-5105FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicenseKB004130MichiganProvider IdentifiersIDDescriptionIssuerID950 D1 5107DescriptionOtherIssuerBCBS PROVIDER IDMichiganIDP52560DescriptionOtherIssuerBCN PROVIDER IDMichiganID2117924DescriptionMedicaidIssuerUnlistedMichigan