Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 005109 | KY |
NPI | 1992962567 |
---|---|
Provider Name | Mrs. Jennifer Lynn Buono |
First Address | Mechanicsburg, PA 17055-6291 |
Second Address | Louisville, KY 40223-4105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 20/04/2016 |