Most Relevant Information
Provider Data
| NPI Number: | 1003048323 |
| Provider Name: | BRIAN RODGERS |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC0200X |
| Specialty: | Registered Nurse |
| License Number: | 68505 |
Most Important Dates
| Enumeration Date: | 08/20/2009 |
| Last Updated: | 08/20/2009 |
Provider Practice Location
202 MAPLEWOOD AVE
RONCEVERTE
WV
249701334
Practice Location Phone/Fax
| Phone: | 3046672855 |
| Fax: |
Provider Mailing Location
202 MAPLEWOOD AVE
RONCEVERTE
WV
249701334
Provider Mailing Phone/Fax
| Phone: | 3046672855 |
| Fax: |