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 today at 10:46 AM.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