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General NPI Number Information
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NPI Number | 1801603089
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Entity Type | Organization
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Legal Business Name | SKYYE SKYNN LLC
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Dates
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Enumeration Date | 12/11/2024
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1441 WOODMONT LN NW STE 3240
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City | ATLANTA
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State | GA
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Zip | 30318-2866
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Country | US
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Telephone | 404-855-2924
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 WOODMONT LN NW STE 3240
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City | ATLANTA
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State | GA
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Zip | 30318-2866
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Country | US
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Telephone | 404-855-2924
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Fax |
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Authorized Official
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Title or Position | COO
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Name | JULIETTE TRACY JOHNSON
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Credential |
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Telephone | 404-531-9096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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