Individual
RYAN BUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
82 COLLEGE LN, DAHLONEGA, GA 30533
(478) 232-8826
Mailing address
82 COLLEGE CIRCLE, DAHLONEGA, GA 30597
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003039
GA
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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