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Individual
MICHAEL ROGERS
Active
Individual
MICHAEL ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A2405649
DRIVER'S LICENSE
CA
Enumeration date
06/13/2016
Last updated
06/13/2016
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