Individual
STACEY LANETTE YARBROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13 AMANDAS CT NW, CARTERSVILLE, GA 30121-4782
(470) 731-4967
Mailing address
13 AMANDAS CT NW, CARTERSVILLE, GA 30121-4782
(470) 731-4967
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
029710902
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
029710902
029710902
GA
Enumeration date
06/13/2022
Last updated
06/13/2022
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