Individual
MELODY MICHELLE ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4016 CASSIMER AVE, DIBERVILLE, MS 39540-2309
(228) 280-8120
Mailing address
4016 CASSIMER AVE, DIBERVILLE, MS 39540-2309
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA6628
MS
Other
Enumeration date
04/15/2019
Last updated
04/15/2019
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