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Individual

DR. LOLA SICARD ROSENBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, PT, MHS, OCS

Contact information

Practice address
405 OSIGIAN BLVD, THE CANTRELL CENTER FOR PHYSICAL THERAPY & SPORTS MEDIC, WARNER ROBINS, GA 31088
(478) 953-3535
(478) 953-0353
Mailing address
405 OSIGIAN BLVD, THE CANTRELL CENTER FOR PHYSICAL THERAPY & SPORTS MEDIC, WARNER ROBINS, GA 31088
(478) 953-3535
(478) 953-0353

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007078
GA
2251X0800X
Orthopedic Physical Therapist
PT007078
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
52130765
BCBS
GA
05
570901821A
GA
Enumeration date
07/07/2006
Last updated
11/14/2014
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