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Individual

DR. CHARLES W RODGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
607 EAST WASHINGTON, RIVERTON, WY 82501
(307) 856-1333
Mailing address
822 N POINT CIR, RIVERTON, WY 82501-3346
(307) 856-1333

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
58
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119106301
WY
Enumeration date
10/09/2008
Last updated
11/02/2008
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