Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | DC002801-L | PA |
NPI | 1184828840 |
---|---|
Provider Name | Dr. Jeffry J Buffenmyer |
First Address | New Holland, PA 17557-1302 |
Second Address | New Holland, PA 17557-1302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131019 | (02) | PA |