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Kittie A Rogers

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NPI Number Detailed Information

Provider Information:

Name: Kittie A Rogers
Gender: F
Provider License Number If Given: 2690

NPI Information:

NPI: 1144229428
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/19/2005

Last Update Date: 3/29/2012

Provider Business Mailing Address:

Address: 504 N WILLIAM ST
Columbia, MO 65201
Phone Number: 5735290732
Fax Number: 5738753183

Provider Business Practice Location Address:

Address: 1204 ROGERS ST SUITE D
Columbia, MO 65201
Phone Number: 5732142253
Fax Number: 5738753183

Provider Taxonomy:

Primary: 101Y00000X
Secondary (if any):
State: MO

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