Individual
GARETT F ROGSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11053-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36182900
—
WI
01
—
823750006
MEDICARE PTAN
WI
Enumeration date
09/12/2007
Last updated
04/03/2013
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