Individual
KIRA JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1055 HOWELL MILL RD, STE 8082 PMB 1050, ATLANTA, GA 30318
(478) 336-6169
Mailing address
1055 HOWELL MILL RD, STE 8082 PMB 1050, ATLANTA, GA 30318
(478) 336-6169
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
GA
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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