Individual
MARY ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 BEVERLY AVE, ROSWELL, NM 88201-8633
(575) 420-9315
Mailing address
2810 BEVERLY AVE, ROSWELL, NM 88201-8633
(575) 420-9315
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
03553700000
NM
Other
Enumeration date
06/29/2021
Last updated
06/29/2021
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