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Organization

CHARLES W RODGERS PHD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES W RODGERS PHD (PRESIDENT)
(307) 856-1333
Entity
Organization

Contact information

Practice address
607 EAST WASHINGTON, RIVERTON, WY 82501
(307) 856-1333
Mailing address
822 NORTH POINTE CIRCLE, RIVERTON, WY 82501
(307) 856-1333

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
58
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119106301
WY
Enumeration date
11/03/2006
Last updated
10/07/2008
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