Individual
KACY ANN ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
105 MELISSA DR, LEXINGTON, IL 61753-1711
(309) 472-2345
Mailing address
105 MELISSA DR, LEXINGTON, IL 61753-1711
(309) 472-2345
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004045
IL
225200000X
Physical Therapy Assistant
160004045
IL
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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