Individual
BRIAN RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 667-2855
Mailing address
202 MAPLEWOOD AVE, RONCEVERTE, WV 24970-1334
(304) 667-2855
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
68505
WV
Other
Enumeration date
08/20/2009
Last updated
08/20/2009
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