Stephanie Grace Sullivan | Woodstock, GA • PECOS Search

Stephanie Grace Sullivan

Chiropractor

Chiropractic Providers

113 Oak Laurel, Woodstock, GA 30188-6721

PECOS Enrollment

Based on the most recent information from CMS, provider Stephanie Grace Sullivan does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 34 days ago.

Profile Details

Provider ID
1629215009
Provider Type
Individual
Full Name
Sullivan, Stephanie Grace
Title
Dr.
Credential
D.C.

Gender
Female
Sole Proprietor
No
Enumeration Date
1/7/2009
Last Updated
12/14/2009

Contact Information

Practice Location

113 Oak Laurel, Woodstock, GA 30188-6721

Unlisted Fax

Mailing Location

113 Oak Laurel, Woodstock, GA 30188-6721

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 111N00000X Primary	Description Chiropractor Chiropractic Providers	License CHIR008394 Georgia