JUSTIN LEE BANISTER

AUGUSTA, GA
NPI1932768223
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: AL  1-160425)
Enumeration Date2019-06-10
Last Update Date2022-09-27
Business Address
JUSTIN LEE BANISTER CRNP
1120 15TH ST
AUGUSTA, GA 30912-0001
Phone number: 706-721-7386
Mailing Address
JUSTIN LEE BANISTER CRNP
1026 IRIS GLEN DR
EVANS, GA 30809-9300
Phone number: 706-604-9005
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