Individual
LISA POTTER BULOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-4214
Mailing address
2210 LAUREL LAKE DR, SUWANEE, GA 30024-3270
(225) 301-3981
(225) 301-3981
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD003543
GA
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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