Individual
LAUREN ELISE CONNOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
300 TOWER RD NE, SUITE 100, MARIETTA, GA 30060-9404
(770) 499-9918
(770) 792-8276
Mailing address
199 14TH ST NE, #2803, ATLANTA, GA 30309-3643
(770) 499-9918
(770) 792-8276
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT008434
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52198163002
BCBS MARIETTA LOCATION
GA
01
—
52198163004
BCBS WOODSTOCK LOCATION
GA
01
—
52198163006
BCBS AUSTELL LOCATION
GA
01
—
52198163008
BCBS DOUGLASVILLE LOCATIO
GA
Enumeration date
07/03/2006
Last updated
07/08/2007
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