Healthcare Provider Details

I. General information

NPI: 1912193269
Provider Name (Legal Business Name): GEORGE T ROGERS C.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BUTTRICK RD BLDG B UNIT 4
LONDONDERRY NH
03053-3352
US

IV. Provider business mailing address

246 PLEASANT STREET SUITE 200
CONCORD NH
03301-2548
US

V. Phone/Fax

Practice location:
  • Phone: 603-425-0106
  • Fax: 603-226-0845
Mailing address:
  • Phone: 603-226-0106
  • Fax: 603-226-0845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: