Individual
JALISA L SPY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1860 SANDY PLAINS RD STE 204, MARIETTA, GA 30066-7864
(614) 999-3665
Mailing address
1860 SANDY PLAINS RD STE 204, MARIETTA, GA 30066-7864
(614) 999-3665
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
06/07/2021
Last updated
08/01/2025
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