Individual
LISA M STILLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
745 SOUTH GLYNN STREET, FAYETTEVILLE, GA 30214
(770) 719-5490
(770) 719-3113
Mailing address
PO BOX 152459, FAYETTEVILLE, GA 30214
(770) 719-5490
(770) 719-3113
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
720353
GA
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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