Individual
KELLY ROKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
700 HEMPHILL ST, FT WORTH, TX 76104-3105
(817) 334-0111
Mailing address
700 HEMPHILL ST, FT WORTH, TX 76104-3105
(817) 334-0111
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
174725
TX
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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