Healthcare Provider Details

I. General information

NPI: 1972873743
Provider Name (Legal Business Name): FRANCES ROGGEN, P.T., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2012
Last Update Date: 08/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 RTE 60
MOUNTAINAIR NM
87036
US

IV. Provider business mailing address

PO BOX 888
MOUNTAINAIR NM
87036-0888
US

V. Phone/Fax

Practice location:
  • Phone: 410-979-6143
  • Fax:
Mailing address:
  • Phone: 410-979-6143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. FRANCES CRONSTEIN ROGGEN
Title or Position: PRESIDENT
Credential: MS, PT
Phone: 410-979-6143