Bridgette Idette Banks, MAT, LAT, ATC

NPI #1508345158 in Canton, Georgia

Provider Information

NPI Number
1508345158
Entity Type
Individual
Name
Bridgette Idette Banks, MAT, LAT, ATC
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Specialist/Technologist - Athletic Trainer
Credential
MAT, LAT, ATC
Enumeration Date
Aug 13, 2018
Last Updated
Aug 13, 2018

Practice Location

Address
111 HICKORY KNOLL DR APT 401
City
Canton
State
Georgia
ZIP Code
30114-2444
Phone
(616) 773-9018

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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