Individual
KIRBY JO BERTRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
6262 VETERANS PARKWAY, COLUMBUS, GA 31909
(706) 324-6661
Mailing address
6600 KITTEN LAKE DRIVE, APT 1021, MIDLAND, GA 31820
(605) 842-6082
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002803
GA
Other
Enumeration date
01/14/2016
Last updated
01/14/2016
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