Individual
RANDI ELLEN ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 RUSSELL ROAD, RUSSELLVILLE, AR 72801
(479) 967-2322
Mailing address
PO DRAWER 2109, RUSSELLVILLE, AR 72811
(479) 967-2322
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175195721
—
AR
Enumeration date
01/02/2009
Last updated
02/01/2023
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