Organization
GWENDOLYN ROGERS, LAC P-LLC
Active
Organization
GWENDOLYN ROGERS, LAC P-LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GWENDOLYN ROGERS ND, LAC (OWNER/PRACTITIONER)
(503) 975-3256
Entity
Organization
Contact information
Practice address
31 ADAMS AVE STE 4, ENDICOTT, NY 13760-5734
(607) 729-0591
Mailing address
1 JOHN ST, ITHACA, NY 14850-6350
(503) 975-3256
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134395221
INDIVIDUAL NPI
OR
Enumeration date
08/22/2026
Last updated
08/22/2026
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