Individual
ZAC ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8543 WINCHESTER AVE, INWOOD, WV 25428-4022
(304) 229-1010
Mailing address
36 WINDSOR LN, BUNKER HILL, WV 25413-2563
(540) 771-0734
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002768
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA002768
PTA LICENSE
WV
Enumeration date
12/13/2021
Last updated
12/13/2021
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