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Individual

ROGER LEON JORGENSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
14222 N 95 SI, LONGMONT, CO 80504
(303) 682-0268
Mailing address
14222 N 95 ST., LONGMONT, CO 80504
(303) 682-0268

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
15771
CO

Other

Enumeration date
03/17/2015
Last updated
03/17/2015
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