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Individual

KELLY E ROGERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.O.T.A.

Contact information

Practice address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-5547
(715) 526-5542
Mailing address
504 LAKELAND RD, SHAWANO, WI 54166-3836
(715) 526-5547
(715) 526-5542

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
625-27
WI

Other

Enumeration date
09/01/2011
Last updated
09/01/2011
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