Individual
JONATHAN PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
156 LONG DR SW, MARIETTA, GA 30060-6642
(770) 639-7069
Mailing address
156 LONG DR SW, MARIETTA, GA 30060-6642
(770) 639-7069
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000021474
GA
246ZX2200X
Orthopedic Assistant
22-1115
GA
Other
Enumeration date
07/07/2015
Last updated
04/19/2023
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