Individual
MS. SHAVON L JONES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4762 LOST COLONY CT, STONE MOUNTAIN, GA 30088-3522
(267) 370-6972
(404) 994-7006
Mailing address
4762 LOST COLONY CT, STONE MOUNTAIN, GA 30088-3522
(267) 370-6972
(404) 994-7006
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
GA
225000000X
Orthotic Fitter
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
881612487
CRANIAL PROSTHESIS
GA
Enumeration date
05/20/2022
Last updated
07/05/2022
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