Individual
MRS. LAUREN K RICKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
340 KENNESTONE HOSPITAL BLVD STE 100, MARIETTA, GA 30060-1158
(770) 281-5100
(678) 581-7100
Mailing address
531 ROSELANE ST NW STE 710, MARIETTA, GA 30060-6975
(678) 331-3297
(678) 581-7187
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
006092
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124310149
NPI NUMBER
GA
Enumeration date
05/10/2011
Last updated
06/08/2019
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