Individual
MR. CHARLES ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 LETTON DR, RATON, NM 87740-4366
(575) 445-8568
(575) 445-0540
Mailing address
101 LETTON DR, RATON, NM 87740-4366
(575) 445-8568
(575) 445-0540
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71525564
—
NM
Enumeration date
11/24/2009
Last updated
11/24/2009
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