Healthcare Provider Details

I. General information

NPI: 1235809823
Provider Name (Legal Business Name): HALEY KRISTINE ROGERS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2021
Last Update Date: 02/23/2022
Certification Date: 02/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 GOLDEN ST STE 120
CALHAN CO
80808-8727
US

IV. Provider business mailing address

6410 BLACK RIDGE VW APT 307
COLORADO SPRINGS CO
80924-4444
US

V. Phone/Fax

Practice location:
  • Phone: 719-347-2399
  • Fax: 719-471-4415
Mailing address:
  • Phone: 919-323-7560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0017936
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: