Individual
MR. BRUCE DAVID INGOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
30TH AG RECEPTION BUILDING 3020, FORT BENNING, GA 31905
(706) 544-8127
Mailing address
1838 HOLLAND RD, CATAULA, GA 31804-3412
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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