Individual
TATIANA MARCUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3895 BUSBY MILL CT., ELLENWOOD, GA 30294
(404) 977-6902
Mailing address
3895 BUSBY MILL CT, ELLENWOOD, GA 30294-2055
(404) 977-6902
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
CO104245
GA
Other
Enumeration date
09/05/2017
Last updated
07/21/2022
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