Provider Demographics
NPI:1841024767
Name:MORRISON, YVETTE ADVENTA
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:ADVENTA
Last Name:MORRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8641 DORRIS RD STE 150C
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30134-2499
Mailing Address - Country:US
Mailing Address - Phone:770-675-9173
Mailing Address - Fax:
Practice Address - Street 1:8641 DORRIS RD STE 150C
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-2499
Practice Address - Country:US
Practice Address - Phone:770-675-9173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier