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1962443515
BONITA L BROCKMAN
AUSTELL, GA
NPI
1962443515
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Other Name
EVAN LAVONNE BROCKMAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208000000X Pediatrics
(Licence: GA 045410)
Enumeration Date
2006-06-08
Last Update Date
2007-07-08
Business Address
-- BONITA L BROCKMAN MD
2041 MESA VALLEY WAY STE 185
AUSTELL, GA 30106
Phone number: 404-785-8900
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Mailing Address
-- BONITA L BROCKMAN MD
361 NELMS AVE
ATLANTA, GA 30307
Phone number: 404-822-7712
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