Individual
WENDY STALLWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2365 SPRING RD SE STE 215, SMYRNA, GA 30080-2632
(513) 400-8349
Mailing address
409 WALTON WAY SE, SMYRNA, GA 30082-3854
(513) 400-8349
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CO125001
GA
Other
Enumeration date
10/16/2023
Last updated
09/09/2024
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