Individual
ELIZABETH THIBODEAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
414 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5056
(770) 389-0090
Mailing address
414 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5056
(770) 389-0090
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
10/26/2015
Last updated
10/26/2015
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