Organization
WOODSTONE ORTHOTICS ,PROSTHETICS & MASTECTOMY
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTEL TATUM (OWNER PRACTITIONER)
(470) 839-0797
Entity
Organization
Contact information
Practice address
2330 SCENIC HWY S, SNELLVILLE, GA 30078-3115
(470) 838-0797
Mailing address
6234 WOODSTONE WAY, MORROW, GA 30260
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
02/25/2015
Last updated
02/25/2015
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