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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 |
