Individual
JERRY RODGERS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7378 FAYETTE BLVD, CHIPPEWA LAKE, OH 44215-9812
(330) 769-4554
Mailing address
7378 FAYETTE BLVD, CHIPPEWA LAKE, OH 44215-9812
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03223315
OH
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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