Provider Demographics
NPI:1205113735
Name:MILLMAN, LAUREN ASHLEY (DC)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ASHLEY
Last Name:MILLMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3984
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-0998
Mailing Address - Country:US
Mailing Address - Phone:770-755-1739
Mailing Address - Fax:
Practice Address - Street 1:4140 MOORE RD
Practice Address - Street 2:SUITE B-114
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-7159
Practice Address - Country:US
Practice Address - Phone:770-755-1739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008895111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor