Individual
TISA ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
306 CHERRY GROVE STREET, DURHAM, NC 27703
(980) 286-2713
(919) 294-6164
Mailing address
306 CHERRY GROVE STREET, DURHAM, NC 27703
(980) 286-2713
(919) 294-6164
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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