Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | PT22507 | FL |
NPI | 1316227911 |
---|---|
Provider Name | Megan M Rogers |
First Address | Coral Gables, FL 33146-2402 |
Second Address | Coral Gables, FL 33146-2402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2011 |
Last Update Date | 26/08/2011 |