Provider Demographics
NPI:1699326702
Name:ARAGON, AUREA (LNMT)
Entity type:Individual
Prefix:
First Name:AUREA
Middle Name:
Last Name:ARAGON
Suffix:
Gender:F
Credentials:LNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 KILLIAN HILL RD SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-4009
Mailing Address - Country:US
Mailing Address - Phone:404-566-1608
Mailing Address - Fax:
Practice Address - Street 1:5335 FIVE FORKS TRICKUM RD SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-6753
Practice Address - Country:US
Practice Address - Phone:404-566-1608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-20
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist