Individual
MS. AJA NICOLE BENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1968 HAWKS LN NE STE 200, BROOKHAVEN, GA 30329-2283
(404) 778-3350
Mailing address
1003 EASTWOOD VILLAGE DR, STOCKBRIDGE, GA 30281-7752
(470) 219-0642
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001613
GA
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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