Individual
VINCENT JOHN R BUSANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
247 S MAIN ST, REIDSVILLE, GA 30453-4605
(912) 557-1000
Mailing address
2200 OLD QUACCO RD # ATP5204, POOLER, GA 31322-0558
(757) 515-9110
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007769
GA
Other
Enumeration date
07/15/2020
Last updated
07/15/2020
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