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Individual
TIMOTHY CARL ROGERS
Active
Individual
TIMOTHY CARL 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
—
F4785167
DRIVER'S LICENSE
CA
Enumeration date
11/23/2015
Last updated
11/23/2015
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