NPI 1366942047

Ellion Profitt

Practitioner Prosthetics Case Management Stone Mountain, GA

Practice location

Address: 5479 Memorial Dr STE 2, Stone Mountain, GA 30083-3247
Phone: (678) 431-6352
Mailing address: 3738 Waldrop Creek CT, Decatur, GA 30034-6723

Registered specialties

Prosthetics Case Management Primary

Other Service Providers Taxonomy 1744P3200X Licence CO101834 (GA)

Other Specialist providers in Georgia →

Registry record

NPI: 1366942047
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 Feb 2018
Record last updated: 19 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.