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General NPI Number Information
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NPI Number | 1265951685
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Entity Type | Individual
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Provider Name | LISA ARNELL STAFFORD-JOHNSON DC
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Gender | Female
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 3755 CARMIA DR SW STE 440
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City | ATLANTA
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State | GA
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Zip | 30331-6253
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Country | US
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Telephone | 404-913-0926
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Fax |
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Provider Business Mailing Address
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Address Line | 3755 CARMIA DR SW STE 440
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City | ATLANTA
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State | GA
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Zip | 30331-6253
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Country | US
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Telephone | 404-913-0926
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHIR009806
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License Number State | GA
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