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General NPI Number Information
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NPI Number | 1407176472
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Entity Type | Individual
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Provider Name | REBECCA ANN BUFFONE DC
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Gender | Female
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Dates
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Enumeration Date | 06/01/2010
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 11707 BOWMAN GREEN DR
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City | RESTON
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State | VA
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Zip | 20190-3501
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Country | US
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Telephone | 571-429-1624
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Fax |
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Provider Business Mailing Address
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Address Line | 3056 CROSEN CT
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City | OAK HILL
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State | VA
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Zip | 20171-1538
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104556886
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License Number State | VA
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