Individual
STACY LYNN ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPS
Contact information
Practice address
228 E PINE ST, LAKELAND, FL 33801-4967
(863) 581-7946
Mailing address
2214 COVENTRY AVE, LAKELAND, FL 33803-3119
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
FL
Other
Enumeration date
08/29/2024
Last updated
08/29/2024
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