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1871156042
BRIAN BASCO
AUGUSTA, GA
NPI
1871156042
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084N0400X Psychiatry & Neurology, Neurology
(Licence: GA 10816)
Enumeration Date
2019-04-15
Last Update Date
2019-04-15
Business Address
BRIAN BASCO
1120 15TH ST
AUGUSTA, GA 30912-0004
Phone number: 706-721-0211
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Mailing Address
BRIAN BASCO
3566 PEBBLE BEACH DR
MARTINEZ, GA 30907-9520
Phone number: 404-783-1582
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