Individual
MR. GARY JOHN RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 467-4606
Mailing address
10806 QUAKER LN N, MAPLE GROVE, MN 55369-2769
(763) 493-3711
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10539
MN
Other
Enumeration date
08/25/2006
Last updated
07/08/2007
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