Provider Demographics
NPI:1619177615
Name:BUCH, JONI MICHELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:JONI
Middle Name:MICHELLE
Last Name:BUCH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 MITCHELL ROAD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421
Mailing Address - Country:US
Mailing Address - Phone:812-275-4419
Mailing Address - Fax:812-275-8044
Practice Address - Street 1:3525 MITCHELL ROAD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421
Practice Address - Country:US
Practice Address - Phone:812-275-4419
Practice Address - Fax:812-275-8044
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002332A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor