Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 38MC00653800 | NJ |
N | 111N00000X | Chiropractor | CHIR006531 | GA |
Y | 111NS0005X | Chiropractic Sports Physician | 5209 | KY |
NPI | 1124056882 |
---|---|
Provider Name | Dr. Timothy Rienzo Rogers |
First Address | Lexington, KY 40509-1952 |
Second Address | Lexington, KY 40509-1952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 12/08/2011 |