Individual provider · NPI-1

Stacy Lynn Elliott, CPS

Prosthetic/Orthotic Supplier · Lakeland, FL

NPI number1043044282
StatusActive
Last updated in NPPESAug 29, 2024

Details

NPI
1043044282
Entity type
Individual (NPI-1)
Name
Stacy Lynn Elliott
Credential
CPS
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 29, 2024
Certification date
Aug 29, 2024
Last updated
Aug 29, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
335E00000X Prosthetic/Orthotic Supplier–FLYes

Practice location

228 E Pine St
Lakeland, FL 33801-4967

Phone 863-581-7946

Mailing address

2214 Coventry Ave
Lakeland, FL 33803-3119

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