Individual
WYATT ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
222 TONGASS DR, SITKA, AK 99835-9416
(907) 966-2411
(907) 966-8383
Mailing address
PO BOX 528, ATTN:BH SOBERING CENTER, BETHEL, AK 99559-0528
(907) 543-6830
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
163WX0106X
Occupational Health Registered Nurse
Primary
NURR38294
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020986
—
AK
Enumeration date
06/04/2014
Last updated
05/08/2019
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