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General NPI Number Information
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NPI Number | 1033407762
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Entity Type | Individual
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Provider Name | TRACY MAE ROGERS DPT
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Gender | Female
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Dates
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Enumeration Date | 07/15/2011
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Last Update Date | 05/25/2021
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Provider Practice Location Address
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Address Line | 3141 CENTENNIAL BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80907-4094
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Country | US
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Telephone | 719-227-4535
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Fax |
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Provider Business Mailing Address
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Address Line | 941 OAK RIDGE RD
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City | MANITOU SPRINGS
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State | CO
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Zip | 80829-2803
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Country | US
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Telephone | 619-823-4568
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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 | 26641
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 0015475
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License Number State | CO
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