Individual
MRS. SHANDA DESHA ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1900 STILLWATER DR, JONESBORO, AR 72404-9119
(870) 932-3600
(870) 932-3611
Mailing address
2919 MARTINBROOK DR, JONESBORO, AR 72401-5923
(870) 931-0762
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2222
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142528721
—
AR
01
—
5Y298
ARBCBS
AR
Enumeration date
01/29/2007
Last updated
07/20/2011
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