Individual
CEDRIC MICHAEL ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
210 VILLAGE CENTER BLVD, MYRTLE BEACH, SC 29579-6706
(843) 353-3460
Mailing address
511 HINSON DR APT 136, MYRTLE BEACH, SC 29579-4443
(910) 674-8138
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4735
SC
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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