Individual
RYAN BONANNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1225 BROADRICK DR, DALTON, GA 30720-2504
(706) 272-6000
Mailing address
1225 BROADRICK DR, DALTON, GA 30720-2504
(706) 272-6000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001260
GA
Other
Enumeration date
11/12/2019
Last updated
11/12/2019
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