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General NPI Number Information
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NPI Number | 1437640935
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Entity Type | Individual
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Provider Name | PAUL BUURMAN
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Gender | Male
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Dates
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Enumeration Date | 05/21/2018
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 4155 DREW RD
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City | CUMMING
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State | GA
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Zip | 30040-9441
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Country | US
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Telephone | 770-888-3470
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Fax |
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Provider Business Mailing Address
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Address Line | 2420 ROSE WALK DR
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City | ALPHARETTA
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State | GA
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Zip | 30005-8331
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Country | US
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Telephone | 678-799-6279
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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