OrganizationActive
Aria London Boutique
NPI 1699356923 · Prosthetic/Orthotic Supplier · Lizella, GA
Provider details
- NPI number
- 1699356923
- Entity type
- Organization
- Primary specialty
- Prosthetic/Orthotic SupplierSuppliers
- Organization subpart
- No
- Authorized official
- Latrese Jackson, Owner(478) 250-4601
Specialties & taxonomies
Suppliers
Practice location
2311 Gwendale Dr E
Lizella, GA 31052-3524
Phone: (478) 250-4601
Approximate (ZIP-level) locationGet directions
Mailing address
2311 Gwendale Dr E
Lizella, GA 31052-3524
Registry dates
- Enumerated
- 2021-04-19
- Last updated
- 2021-04-19
- Certified
- 2021-04-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.