Individual
MR. MARK ROGOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.,C.
Contact information
Practice address
NSWG1 LOGSU MEDICAL SPORTS MEDICINE, 3632 GUADALCANAL RD - BLDG #165, SAN DIEGO, CA 92155-5583
(619) 537-3264
Mailing address
NSWG1 LOGSU MEDICAL SPORTS MEDICINE, 3632 GUADALCANAL RD - BLDG #165, SAN DIEGO, CA 92155-5583
(619) 537-3264
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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