Provider Demographics
NPI:1164597068
Name:COURSON, RONALD WAYNE (ATC, PT, NREMT-I)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:WAYNE
Last Name:COURSON
Suffix:
Gender:M
Credentials:ATC, PT, NREMT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 SELIG CIR
Mailing Address - Street 2:BUTTS-MEHRE HALL
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602-1501
Mailing Address - Country:US
Mailing Address - Phone:706-542-9060
Mailing Address - Fax:706-542-9061
Practice Address - Street 1:1 SELIG CIR
Practice Address - Street 2:BUTTS-MEHRE HALL
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-1501
Practice Address - Country:US
Practice Address - Phone:706-542-9060
Practice Address - Fax:706-542-9061
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA32499146M00000X
GAPT004698225100000X
GAAT0003792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer