Individual
DONNA ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5335 FIVE FORKS TRICKUM RD SW, LILBURN, GA 30047-6753
(404) 405-0346
(404) 298-0789
Mailing address
3870 LOBLOLLY DR, CLARKSTON, GA 30021-3012
(404) 405-0346
(404) 298-0789
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29665400
GA
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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