Individual
BRANDON TYLER ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1658 US HIGHWAY 371, PRESCOTT, AR 71857-7064
(870) 887-3660
Mailing address
2904 ARKANSAS BLVD, TEXARKANA, AR 71854-2536
(870) 773-4655
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/17/2018
Last updated
08/17/2018
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