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General NPI Number Information
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NPI Number | 1366681496
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Entity Type | Individual
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Provider Name | AMY SUZAN ROGERS OTR
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Gender | Female
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Dates
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Enumeration Date | 02/12/2009
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Last Update Date | 02/12/2009
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Provider Practice Location Address
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Address Line | 1104 E GRACE ST
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City | RENSSELAER
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State | IN
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Zip | 47978-3211
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Country | US
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Telephone | 219-866-5141
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Fax |
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Provider Business Mailing Address
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Address Line | 635 S FROST DR
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City | SAGINAW
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State | MI
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Zip | 48638-6083
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Country | US
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Telephone | 989-284-4535
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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 | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 5201006443
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License Number State | MI
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