Individual
DONNA ROGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED OPTICIAN
Contact information
Practice address
2714 MARCONI AVE, SACRAMENTO, CA 95821-4914
(916) 291-3212
Mailing address
2714 MARCONI AVE, SACRAMENTO, CA 95821-4914
(916) 291-3212
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SL5933
CA
Other
Enumeration date
05/13/2016
Last updated
05/13/2016
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