Healthcare Provider Details

I. General information

NPI: 1609056738
Provider Name (Legal Business Name): JOHN ALLEN ROGERS D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2007
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 N WEST ST
SILVER CITY NM
88061-4635
US

IV. Provider business mailing address

1205 N WEST ST
SILVER CITY NM
88061-4635
US

V. Phone/Fax

Practice location:
  • Phone: 575-538-2558
  • Fax: 575-538-3996
Mailing address:
  • Phone: 575-538-2558
  • Fax: 575-538-3996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number835
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: