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Mr. Steven Anthony Rodgers

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NPI Number Detailed Information

Provider Information:

Name: Mr. Steven Anthony Rodgers
Gender: M
Provider License Number If Given: 56007277

NPI Information:

NPI: 1679572101
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 4/12/2012

Provider Business Mailing Address:

Address: 850 43RD AVE STE 100
Moline, IL 61265
Phone Number: 3097432070
Fax Number: 3097432073

Provider Business Practice Location Address:

Address: 520 VALLEY VIEW DR STE 200
Moline, IL 61265
Phone Number: 3097970866
Fax Number: 3097970872

Provider Taxonomy:

Primary: 225X00000X
Secondary (if any): 225X00000X
State: IL

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