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Individual

JESUS E AVILES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
755 BATTERY AVE SE, ATLANTA, GA 30339-3017
(404) 577-9100
Mailing address
HC 5 BOX 7281, YAUCO, PR 00698-9721
(787) 207-7302

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0001904
CO

Other

Enumeration date
09/01/2020
Last updated
09/01/2020
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