Individual
DENISE ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1619 CANTON ST, ELKHART, IN 46514-3443
(574) 333-7331
Mailing address
1619 CANTON ST, ELKHART, IN 46514-3443
(574) 350-8601
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
06002317A
IN
Other
Enumeration date
10/13/2011
Last updated
09/17/2014
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