Individual
KEZIAH RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 GEORGE BISHOP PKWY, MYRTLE BEACH, SC 29579-7335
(800) 805-6989
Mailing address
1182 BETHPAGE DR, MYRTLE BEACH, SC 29579-7926
(501) 766-6018
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
224230
AR
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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