Individual
THERESA ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
27725 CORDOBA, FARMINGTON HILLS, MI 48334-3973
(810) 333-1197
Mailing address
27725 CORDOBA, FARMINGTON HILLS, MI 48334-3973
(810) 333-1197
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703062289
MI
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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