Individual
THERESA LYNN ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
40 CARRUTHERS PL, NORTH TONAWANDA, NY 14120
(541) 699-9433
Mailing address
40 CARRUTHERS PL, NORTH TONAWANDA, NY 14120
(541) 699-9433
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
322756637
NY
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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