Individual
DR. MICHAEL ROLLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
997 SAINT SEBASTIAN WAY, AUGUSTA, GA 30912-2613
(706) 721-6719
Mailing address
997 SAINT SEBASTIAN WAY, AUGUSTA, GA 30912-2613
(706) 721-6719
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003572
GA
207LA0401X
Addiction Medicine (Anesthesiology) Physician
PSY003572
GA
Other
Enumeration date
10/06/2009
Last updated
04/12/2023
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