Individual
MR. DANIEL RODGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
2ND BN 9TH MAR, 2ND MARINE DIVISION, PSC 20002, CAMP LEJEUNE, NC 28542-0002
(910) 450-9434
Mailing address
2301 INDIAN DR APT 63, JACKSONVILLE, NC 28546-5260
(757) 376-7250
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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