Individual
MATTHEW PANETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
231 W HANCOCK ST, MILLEDGEVILLE, GA 31061-3375
(770) 757-7856
Mailing address
6510 PINE RIDGE CIR, CUMMING, GA 30041-4728
(770) 757-7856
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
954378970
UNITED HEALTHCARE
GA
Enumeration date
01/15/2019
Last updated
01/15/2019
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