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Individual

JUSTIN RYAN ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
300 14TH ST APT 1506, SAN DIEGO, CA 92101-7853
(417) 569-8790
Mailing address
300 14TH ST APT 1506, SAN DIEGO, CA 92101-7853

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
06/09/2026
Last updated
06/09/2026
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