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General NPI Number Information
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NPI Number | 1922895622
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Entity Type | Individual
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Provider Name | LA'RIKA VONYEA SMITH
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Gender | Female
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 01/11/2026
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Provider Practice Location Address
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Address Line | 4045 FIVE FORKS TRICKUM RD SW SUITE BP9 #8051
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City | LILBURN
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State | GA
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Zip | 30047
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Country | US
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Telephone | 404-862-2815
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Fax | 404-286-1670
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Provider Business Mailing Address
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Address Line | 5 CARTERET PL
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City | DECATUR
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State | GA
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Zip | 30032-2382
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Country | US
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Telephone | 404-862-6815
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Fax | 404-286-1670
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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