Individual
TARA MAE RODGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
W6040 BUCKLIN RD, ONALASKA, WI 54650-8806
(920) 765-3353
Mailing address
W6040 BUCKLIN RD, ONALASKA, WI 54650-8806
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
178581
WI
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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