Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lilburn Shoe Repair & Pedorthics Inc

Organization Durable Medical Equipment & Medical Supplies · NPI 1063564367

Lilburn Shoe Repair & Pedorthics Inc is a Durable Medical Equipment & Medical Supplies in Lilburn, Georgia. Licensed in Georgia. Registered with an NPI since 2007.

Licensed in
GA
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4760 Lawrenceville Hwy NW Ste C-1
Lilburn, GA 30047-3858
Phone: (770) 931-0823
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Durable Medical Equipment & Medical Supplies (primary) Taxonomy 332B00000X · Licence 9914 (GA)

Record details

NPI number1063564367
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jackie Leandro — Owner · (770) 931-0823
Other names Lilburn Shoe Repair And Pedorthics Inc; Lilburn Shoe Repair And Pedorthics Inc
NPI enumeratedJanuary 17, 2007
Last updated in NPPESFebruary 17, 2021
Certification dateFebruary 17, 2021
Mailing address2605 Sims Crest Ct, Snellville, GA 30078-4161

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