Healthcare Provider Details

I. General information

NPI: 1851227516
Provider Name (Legal Business Name): TERESA LAGENE RINER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5795 US HIGHWAY 221 # B
SOPERTON GA
30457-5805
US

IV. Provider business mailing address

5795 US HIGHWAY 221 # B
SOPERTON GA
30457-5805
US

V. Phone/Fax

Practice location:
  • Phone: 478-697-1534
  • Fax:
Mailing address:
  • Phone: 478-697-1534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number92-0344418
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: