Individual
KIM KOREEN RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, AT/L
Contact information
Practice address
22800 N 67TH AVE, GLENDALE, AZ 85310-4235
(623) 376-4738
Mailing address
2732 W VIA BONA FORTUNA, PHOENIX, AZ 85086-6671
(623) 516-0402
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0071
AZ
Other
Enumeration date
07/20/2006
Last updated
12/26/2013
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