Individual
EVELYN JANET ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 YORKTOWN DR, RUTHER GLEN, VA 22546-5158
(804) 448-4965
(877) 698-5529
Mailing address
130 YORKTOWN DR, RUTHER GLEN, VA 22546-5158
(804) 448-4965
(877) 698-5529
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
12141
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166339330
—
VA
Enumeration date
08/21/2015
Last updated
08/21/2015
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