Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT001379E | PA |
NPI | 1043282874 |
---|---|
Provider Name | Mr. William Parker Rogers |
First Address | Mc Kees Rocks, PA 15136-1415 |
Second Address | Mc Kees Rocks, PA 15136-1415 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 01/07/2010 |