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Individual
ROGER MASON
Active
Individual
ROGER MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003196L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116951
HEALTH AMER/HEALTH ASSUR.
PA
01
—
5303609
AETNA
PA
01
—
MA762952
HIGHMARK BLUE SHIELD
PA
Enumeration date
10/13/2006
Last updated
01/14/2015
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