Individual
DR. TONY BANGUILAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
960 HERRINGTON RD, SUITE B, LAWRENCEVILLE, GA 30044-7212
(770) 963-5585
(770) 682-7636
Mailing address
960 HERRINGTON RD, SUITE B, LAWRENCEVILLE, GA 30044-7212
(770) 963-5585
(770) 682-7636
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CHIR006452
GA
Other
Enumeration date
06/19/2007
Last updated
07/08/2007
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