Individual
MISS KELLY ANN ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, LMT, BS
Contact information
Practice address
404 WEST BLACKHAWK DRIVE, SUITE 1LL, BYRON, IL 61010
(815) 234-5561
(815) 234-5870
Mailing address
404 WEST BLACKHAWK DRIVE, SUITE 1LL, BYRON, IL 61010
(815) 234-5561
(815) 234-5870
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005347
IL
Other
Enumeration date
01/12/2010
Last updated
01/12/2010
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