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1346594959
BONITA PONDER
LOGANVILLE, GA
NPI
1346594959
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA RN149123)
Enumeration Date
2012-11-05
Last Update Date
2020-01-18
Business Address
Mrs. BONITA PONDER FNP
2720 LOGANVILLE HWY
LOGANVILLE, GA 30052-7715
Phone number: 770-277-5996
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Mailing Address
Mrs. BONITA PONDER FNP
2720 LOGANVILLE HWY
LOGANVILLE, GA 30052-7715
Phone number: 770-277-5996
Copy
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