Tackett, Susan Denise

Tackett, Susan Denise is an sole proprietor health care provider with primary practice located at 696 Breedlove Dr Suite B5, Monroe GA 30655-2052. She recently has only one registered license in Other Service Providers / Contractor, which is considered as her primary health care specialty. Tackett, Susan Denise can be contacted via phone (404) 713-7011.

Contact Information

Primary practice address
696 Breedlove Dr Suite B5 Monroe GA 30655-2052
Phone: (404) 713-7011
Fax: (770) 207-7196
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X

Profile Details

NPI number 1063505352
LBN Legal business name Tackett, Susan Denise
Credentials CPED
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 1st, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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