Provider Demographics
NPI:1215984596
Name:BUONANO, JENNIFER (DC)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:BUONANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8232 W CACTUS RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-5218
Mailing Address - Country:US
Mailing Address - Phone:623-878-1133
Mailing Address - Fax:480-393-5771
Practice Address - Street 1:8232 W CACTUS RD
Practice Address - Street 2:SUITE 120
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-5218
Practice Address - Country:US
Practice Address - Phone:623-878-1133
Practice Address - Fax:480-393-5771
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7407111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ76986Medicare ID - Type Unspecified