Individual
EARNESTINE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4127 PLAZA DR, TIFTON, GA 31794-6148
(229) 646-2217
Mailing address
4127 PLAZA DR, TIFTON, GA 31794-6148
(229) 646-2217
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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