Individual
CANDACE ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1807 W MOLINE ST, MALVERN, AR 72104-2645
(501) 467-3166
Mailing address
388 DALLAS 119, FORDYCE, AR 71742-8609
(870) 352-2573
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
08/24/2017
Last updated
08/24/2017
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