Individual
LORRIE K ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3615 BRASELTON HWY STE 101, DACULA, GA 30019-5907
(770) 904-0772
Mailing address
PO BOX 518, JONESBORO, GA 30237-0518
(770) 631-8277
(770) 631-9403
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
003305
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT003305
PT LISC #
GA
Enumeration date
12/14/2006
Last updated
07/08/2007
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