Individual
DR. KENNETH JOHN ROSENGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1365 CLIFTON RD NE STE 1100, ATLANTA, GA 30322-1013
(404) 778-5820
(404) 778-5609
Mailing address
1365 CLIFTON RD NE STE 1100, ATLANTA, GA 30322-1013
(404) 778-5820
(404) 778-5609
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT001817
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00862529 A
—
GA
Enumeration date
07/15/2006
Last updated
07/08/2007
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