Individual
DR. PETRA DIANA ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1904 19TH AVE, RITE AID PHARMACY #5408, LEWISTON, ID 83501-4069
(208) 743-9127
(208) 743-4777
Mailing address
1904 19TH AVE, RITE AID PHARMACY #5408, LEWISTON, ID 83501-4069
(208) 743-9127
(208) 743-4777
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5732
ID
Other
Enumeration date
03/01/2007
Last updated
07/08/2007
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