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Individual

MICHAEL RENE ROGERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
1031 W 25TH AVE, COVINGTON, LA 70433-1321
(985) 789-0983
Mailing address
1031 W 25TH AVE, COVINGTON, LA 70433-1321
(985) 789-0983

Taxonomy

Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
LA 2731
LA
247100000X
Radiologic Technologist
Primary
10800
LA

Other

Enumeration date
09/18/2008
Last updated
03/07/2016
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