Individual
MS. CHANTAY T MARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPECIALIST
Contact information
Practice address
4531 OLDE PERIMETER WAY STE 101, DUNWOODY, GA 30346-4208
(404) 717-2714
Mailing address
115 ARBOR LAKE DR, COVINGTON, GA 30016-0288
(404) 717-2714
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CO119586
GA
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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