Provider Demographics
NPI:1457411498
Name:BUFFIE, JARED (DC)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:BUFFIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 SHARON CIR
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6836
Mailing Address - Country:US
Mailing Address - Phone:678-935-1477
Mailing Address - Fax:
Practice Address - Street 1:5910 BETHELVIEW RD
Practice Address - Street 2:SUITE C
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-6385
Practice Address - Country:US
Practice Address - Phone:770-573-2777
Practice Address - Fax:404-581-5000
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007492111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor