Individual
MICHAEL BUONOPANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
161 COLLEGE AVE, MEDFORD, MA 02155-5528
(617) 627-5102
Mailing address
161 COLLEGE AVE, MEDFORD, MA 02155-5528
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2378
MA
Other
Enumeration date
01/17/2017
Last updated
01/17/2017
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