Individual
SANDI JACQUELYN STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
431 W PONCE DE LEON AVE, SUITE 7, DECATUR, GA 30030-2458
(404) 964-1072
Mailing address
795 KELLS RIDGE DR, ELLIJAY, GA 30540-2353
(404) 964-1072
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
004092
GA
Other
Enumeration date
03/05/2008
Last updated
01/02/2013
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