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General NPI Number Information
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NPI Number | 1962679340
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Entity Type | Organization
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Legal Business Name | JORGE A. BUENO CHIROPRACTIC LLC
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 11/15/2025
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Provider Practice Location Address
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Address Line | 2161 CEDARCREST RD STE 115
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City | ACWORTH
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State | GA
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Zip | 30101-6404
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Country | US
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Telephone | 678-574-4878
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Fax | 678-574-4899
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Provider Business Mailing Address
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Address Line | 2161 CEDARCREST RD STE 115
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City | ACWORTH
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State | GA
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Zip | 30101-6404
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Country | US
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Telephone | 770-386-0222
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Fax | 678-574-4878
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC/OWNER
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Name | JORGE BUENO
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Credential | DC
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Telephone | 770-386-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | CHIR007057
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License Number State | GA
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