Provider Demographics
NPI:1750162772
Name:ROZIER, LASHUNDRA RENEE
Entity type:Individual
Prefix:
First Name:LASHUNDRA
Middle Name:RENEE
Last Name:ROZIER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3105 VALLEY BROOK PL
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-4449
Mailing Address - Country:US
Mailing Address - Phone:470-845-3384
Mailing Address - Fax:
Practice Address - Street 1:2310 LAVISTA WALK NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3770
Practice Address - Country:US
Practice Address - Phone:470-845-3384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier