Individual
GARRETT BONNER LAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
5671 CALVIN DR, MACON, GA 31210-8002
(478) 477-6505
Mailing address
5671 CALVIN DR, MACON, GA 31210-8002
(478) 477-6505
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000784
GA
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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