ELLEN SURATT STANBACK

LITHONIA, GA
NPI1780768663
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: GA  LD001907)
Enumeration Date2006-10-25
Last Update Date2007-07-08
Business Address
-- ELLEN SURATT STANBACK RD,LD,CLC
2277 STONE MOUNTAIN LITHONIA RD
LITHONIA, GA 30058-5252
Phone number: 770-484-2600
Mailing Address
-- ELLEN SURATT STANBACK RD,LD,CLC
3177 KENSINGTON RD
AVONDALE ESTATES, GA 30002-1457
Phone number: 404-299-1150
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