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General NPI Number Information
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NPI Number | 1023941028
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Entity Type | Individual
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Provider Name | NICHOLE MARIE RODGERS PT
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Gender | Female
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Dates
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Enumeration Date | 06/08/2026
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Last Update Date | 06/08/2026
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Provider Practice Location Address
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Address Line | 9405 FAIRWAY VIEW PL
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-0932
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Country | US
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Telephone | 909-481-7345
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Fax |
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Provider Business Mailing Address
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Address Line | 503 CALLE MONTEREY
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City | SAN DIMAS
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State | CA
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Zip | 91773-3943
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Country | US
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Telephone | 626-422-6727
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 310094
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License Number State | CA
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