Individual
JONATHAN SOLARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1430 JOHN WESLEY GILBERT DR GC 4265, AUGUSTA, GA 30912-7741
(919) 943-0252
Mailing address
1430 JOHN WESLEY GILBERT DRIVE GC 4265, AUGUSTA, GA 30912-0001
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/25/2021
Last updated
04/28/2021
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