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Individual

VICTORIA BRIANA BONOMO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1131 BANKHEAD HWY STE 100, CARROLLTON, GA 30116-8703
(678) 890-7648
Mailing address
174 TWIN OAKS LN, DALLAS, GA 30157-3859
(828) 243-7625

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12942
GA

Other

Enumeration date
05/06/2024
Last updated
09/16/2025
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