Individual
DEREK JOHN SURANIE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MED.,ATC
Contact information
Practice address
130 GEORGIA CIRCLE, DAHLONEGA, GA 30597-0001
(706) 867-2770
(706) 867-2865
Mailing address
1775 ADMIRALS POINTE, CUMMING, GA 30041-8667
(678) 947-1282
(706) 867-2865
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000606
GA
Other
Enumeration date
04/13/2006
Last updated
07/08/2007
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