Individual
JEREMIAH RYAN RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6019 WALNUT GROVE RD, MEMPHIS, TN 38120-2113
(901) 226-5000
Mailing address
PO BOX 634760, CINCINNATI, OH 45263-4760
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
TN
Other
Enumeration date
08/20/2008
Last updated
08/20/2008
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