Individual
MR. WILLIAM PRESTON BAZEMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
11320 WOODSTOCK RD, ROSWELL, GA 30075-2548
(678) 277-9083
(678) 277-9756
Mailing address
1907 GRANT LN, WOODSTOCK, GA 30188-2958
(678) 618-1209
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000548
GA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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