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General NPI Number Information
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NPI Number | 1316604036
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH RODGERS OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/17/2021
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 1225 BROADRICK DR
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City | DALTON
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State | GA
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Zip | 30720-2504
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Country | US
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Telephone | 706-278-9355
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Fax |
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Provider Business Mailing Address
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Address Line | 801 CHATTANOOGA AVE APT A125
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City | DALTON
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State | GA
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Zip | 30720-8876
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Country | US
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Telephone | 336-804-0233
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | OT008273
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License Number State | GA
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