Individual
ADDISON BRYNNE MIENERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6450 IVEY MANOR DR, CUMMING, GA 30040-6684
(770) 878-7660
Mailing address
6450 IVEY MANOR DR, CUMMING, GA 30040-6684
(770) 878-7660
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
058916984
GA
Other
Enumeration date
07/10/2019
Last updated
07/10/2019
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