Individual
YOLANDA POLK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 PROMENADE PKWY STE A, FAYETTEVILLE, GA 30214-7713
(504) 914-1416
Mailing address
2613 BLUESTONE DR SW, ATLANTA, GA 30331-9498
(504) 914-1416
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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