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1366942047
ELLION PROFITT
STONE MOUNTAIN, GA
NPI
1366942047
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1744P3200X Specialist, Prosthetics Case Management
(Licence: GA CO101834)
Enumeration Date
2018-02-19
Last Update Date
2018-02-19
Business Address
ELLION PROFITT
5479 MEMORIAL DR STE 2
STONE MOUNTAIN, GA 30083-3247
Phone number: 678-431-6352
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Mailing Address
ELLION PROFITT
3738 WALDROP CREEK CT
DECATUR, GA 30034-6723
Phone number: 678-431-6352
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