JAMES BRIAN BOULWARE

LILBURN, GA
NPI1982739041
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: GA  AT001328)
Enumeration Date2007-02-22
Last Update Date2011-05-25
Business Address
-- JAMES BRIAN BOULWARE MA, ATC, OTC, LAT
475 BRUCE WAY SW
LILBURN, GA 30047-3025
Phone number: 678-764-6364
Mailing Address
-- JAMES BRIAN BOULWARE MA, ATC, OTC, LAT
1014 SYCAMORE DR SUITE B
DECATUR, GA 30030-1644
Phone number: 404-299-1700
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