Healthcare Provider Details

I. General information

NPI: 1801639059
Provider Name (Legal Business Name): CURTIS ROGERS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1885 W 120TH AVE
WESTMINSTER CO
80234-3279
US

IV. Provider business mailing address

8470 DECATUR ST APT 92
WESTMINSTER CO
80031-3816
US

V. Phone/Fax

Practice location:
  • Phone: 720-583-2146
  • Fax:
Mailing address:
  • Phone: 505-690-9513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberPTL.0019919
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: