MEDICARE: JORGE A. BUENO CHIROPRACTIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	CHIR007057	GA

General Provider Information

NPI Number	:	1962679340
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JORGE A. BUENO CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	2161 CEDARCREST RD STE 115
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-6404
Country	:	US
Telephone Number	:	770-386-0222
Fax Number	:	678-574-4899

Provider Business Practice Location Address
First Line	:	2161 CEDARCREST RD STE 115
Second Line	:
City	:	ACWORTH
State	:	GA
Zip	:	30101-6404
Country	:	US
Telephone Number	:	678-574-4878
Fax Number	:	678-574-4899

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. JORGE BUENO
Credential	:	DC
Telephone Number	:	770-386-0222

Provider Enumeration Date	:	05/14/2008
Last Update Date	:	02/20/2026

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