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General NPI Number Information
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NPI Number | 1396027546
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Entity Type | Individual
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Provider Name | RITA ROGERS N.M.T.
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Gender | Female
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 2330 SCENIC HWY S SUITE 313
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City | SNELLVILLE
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State | GA
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Zip | 30078-3115
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Country | US
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Telephone | 678-471-0867
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 WINDLAKE DR
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City | SNELLVILLE
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State | GA
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Zip | 30039-5243
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Country | US
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Telephone | 678-471-0867
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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 | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | MT003152
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License Number State | GA
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