Individual
MR. RAYMOND LESLIE BURNETT IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3240 NORTHEAST EXPY NE, ATLANTA, GA 30341-4003
(404) 480-9330
Mailing address
3240 N E EXPY NE, ATLANTA, GA 30341-4003
(404) 480-9330
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003781
GA
Other
Enumeration date
07/23/2018
Last updated
11/21/2021
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