Individual
LORI ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP, PTA
Contact information
Practice address
5445 BASSWOOD BLVD, STE. 680, FORT WORTH, TX 76137-4437
(817) 770-0017
Mailing address
5445 BASSWOOD BLVD, STE. 680, FORT WORTH, TX 76137-4437
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT049232
TX
Other
Enumeration date
03/01/2010
Last updated
03/01/2010
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