Individual
STACY L POTTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
529 LESTER RD, FAYETTEVILLE, GA 30215-5248
(404) 425-3780
(404) 425-3780
Mailing address
1336 HIGHWAY 54 W, FAYETTEVILLE, GA 30214-4573
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
08/23/2025
Last updated
08/23/2025
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