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General NPI Number Information
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NPI Number | 1164919023
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Entity Type | Individual
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Provider Name | JANET RODGER
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Gender | Female
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Dates
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Enumeration Date | 04/17/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 111 CLARA BARTON ST
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City | DANSVILLE
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State | NY
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Zip | 14437-9503
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Country | US
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Telephone | 585-335-2583
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Fax | 585-335-2587
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Provider Business Mailing Address
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Address Line | 2469 STATE ROUTE 19 N
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City | WARSAW
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State | NY
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Zip | 14569-9336
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Country | US
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Telephone | 585-786-8505
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Fax | 585-786-8490
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 006946-1
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License Number State | NY
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