Individual
PRANAY RAMESH SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC/L
Contact information
Practice address
4450 NELSON BROGDON BLVD, SUITE D1, BUFORD, GA 30518-3447
(770) 793-9999
(877) 619-3810
Mailing address
4450 NELSON BROGDON BLVD, SUITE D1, BUFORD, GA 30518-3447
(770) 793-9999
(877) 619-3810
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001910
GA
Other
Enumeration date
10/10/2011
Last updated
10/10/2011
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