Individual
MRS. HARPER MOULTON ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(800) 836-7536
Mailing address
4040 PRESIDENTIAL BLVD APT 2401, PHILADELPHIA, PA 19131-1730
(619) 454-3528
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT008036
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RT008036
PRIVATE INSURANCE
PA
Enumeration date
08/01/2022
Last updated
08/01/2022
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