Individual
MS. BONNIE JEAN RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1061 HARMON AVENUE, FORT STEWART, GA 31314-5274
(912) 435-5872
Mailing address
1061 HARMON AVENUE, FORT STEWART, GA 31314-5274
(912) 435-5872
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103017
NC
Other
Enumeration date
02/13/2006
Last updated
05/26/2009
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