Provider Demographics
NPI:1063760635
Name:CORTJENS, LAUREN ASHLEY (DC)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ASHLEY
Last Name:CORTJENS
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 1:1730 COMMONWEALTH AVE
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-6722
Mailing Address - Country:US
Mailing Address - Phone:770-235-1575
Mailing Address - Fax:
Practice Address - Street 1:3985 LAKEFIELD CT STE 206
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1209
Practice Address - Country:US
Practice Address - Phone:470-239-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009018111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician