Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 4860 | TN |
NPI | 1194022764 |
---|---|
Provider Name | Miss Sara Ann Rogers |
First Address | Scotts Hill, TN 38374-5071 |
Second Address | Mc Kenzie, TN 38201-1636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2011 |
Last Update Date | 17/02/2011 |