Individual
GERALD ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3570 SAINT JOHNS LN, ELLICOTT CITY, MD 21042-4020
(410) 465-1080
Mailing address
PO BOX 276, WEST FRIENDSHIP, MD 21794-0276
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15600
LICENSE #
MD
Enumeration date
08/29/2006
Last updated
07/08/2007
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