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Individual
ROGER KEITH RATHBONE
Active
Individual
ROGER KEITH RATHBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305002464
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00V829K76
MEDICARE
—
01
—
102450
ANTHEM
—
01
—
426163
ALLIANCE PPO LLC
—
01
—
5318282
AETNA
—
01
—
541669371
TRICARE NORTH REGION
—
01
—
6400902
UNITED HEALTHCARE
—
01
—
P00175805
PALMETTO GBA
—
Enumeration date
12/13/2005
Last updated
10/25/2012
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