Individual
SUSAN GROGAN SEMMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPO/LPO
Contact information
Practice address
404 NORTHSIDE DR, STE D, VALDOSTA, GA 31602-1866
(229) 245-8009
(229) 247-2090
Mailing address
404 NORTHSIDE DR, STE D, VALDOSTA, GA 31602-1866
(229) 245-8009
(229) 247-2090
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
GA 000004
GA
224P00000X
Prosthetist
Primary
GA 000004
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000690852A
—
GA
01
—
C15505
BOC CPO
GA
01
—
CPO02244
ABC CPO
GA
01
—
LPO 000004
GEORGIA LICENSE
GA
Enumeration date
02/15/2013
Last updated
02/15/2013
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