Individual
TRACI ANN ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
45 NW GREELEY AVE, BEND, OR 97703-2943
(541) 550-7800
Mailing address
61592 ORION DR, BEND, OR 97702-2402
(541) 728-3736
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
BAP-E-10239095
OR
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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