NPI 1942852884

Stacie Gullatt

Practitioner Mastectomy Fitter Decatur, GA

Practice location

Address: 2948 Laguna Dr, Decatur, GA 30032-3526
Phone: (404) 513-6170

Registered specialties

Mastectomy Fitter Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224900000X

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Registry record

NPI: 1942852884
Entity type: Individual
Sex (as registered): Female
NPI issued: 11 Jul 2019
Record last updated: 11 Jul 2019

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.