Individual
GARY BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
300 HOSPITAL RD, FORT GORDON, GA 30905
(706) 787-1266
Mailing address
300 HOSPITAL ROAD, FORT GORDON, GA 30905
(706) 495-5790
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN165014
GA
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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