Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Marquetta Bullard

Individual provider Prosthetic/Orthotic Supplier · NPI 1558018937

Marquetta Bullard is a Prosthetic/Orthotic Supplier in Stone Mountain, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2022
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Practice location Address checks out

659 Wren Walk
Stone Mountain, GA 30087-7204
Phone: (404) 429-1470
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Prosthetic/Orthotic Supplier (primary) Taxonomy 335E00000X · Licence CO138476 (GA)

Record details

NPI number1558018937
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 7, 2022
Last updated in NPPESMarch 9, 2022
Certification dateMarch 9, 2022
Mailing address659 Wren Walk, Stone Mountain, GA 30087-7204

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