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Marquetta Bullard
Prosthetic/Orthotic Supplier in Stone Mountain, Georgia
NPI 1558018937

Marquetta Bullard is a Prosthetic/Orthotic Supplier based in Stone Mountain, GA. Marquetta Bullard practices in Stone Mountain, GA. The NPI Number for Marquetta Bullard is 1558018937 and holds a License No. CO138476 (Georgia).

The current practice location address for Marquetta Bullard is 659 Wren Walk, Stone Mountain, GA and can be reached out via phone at 404-429-1470. You can also correspond with Marquetta Bullard through the mailing address at 659 WREN WALK, STONE MOUNTAIN, GA - 30087-7204 (mailing address contact number: 404-429-1470).

Location: 659 Wren Walk, Stone Mountain, GA, 30087-7204
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1558018937
Provider Name
Marquetta Bullard
Credential
Provider Entity Type
Individual
Gender
Female
Address
659 Wren Walk, Stone Mountain, GA, 30087-7204
Phone Number
404-429-1470
Fax Number
Provider Enumeration Date
03/07/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
659 Wren Walk
City
Stone Mountain
State
Georgia
Zip
30087-7204
Phone Number
404-429-1470
Fax Number
person
Provider Business Mailing Address Details
Address
659 Wren Walk
City
Stone Mountain
State
Georgia
Zip
30087-7204
Phone Number
404-429-1470
Fax Number
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
CO138476 (Georgia)
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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