Individual
MRS. MARILYN D. BONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
445 WINN WAY, DECATUR, GA 30030-1707
(404) 508-7866
Mailing address
4360 LEHIGH LAURAL LN, DECATUR, GA 30034-6461
(770) 323-1635
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN061754
GA
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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