Healthcare Provider Details

I. General information

NPI: 1467385369
Provider Name (Legal Business Name): AQUASHA JONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

960 S CITY BLVD # 2015
WAYCROSS GA
31501-4286
US

IV. Provider business mailing address

960 S CITY BLVD # 2015
WAYCROSS GA
31501-4286
US

V. Phone/Fax

Practice location:
  • Phone: 912-514-1014
  • Fax:
Mailing address:
  • Phone: 912-514-1014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: