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General NPI Number Information
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NPI Number | 1730427956
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Entity Type | Individual
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Provider Name | MICHAEL DENNIS ROGERS PT
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Gender | Male
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 12/11/2017
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Provider Practice Location Address
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Address Line | 3680 SANGANI BLVD SUITE D
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City | DIBERVILLE
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State | MS
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Zip | 39540-8703
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Country | US
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Telephone | 601-714-0315
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Fax | 601-714-0316
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Provider Business Mailing Address
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Address Line | 2781 CT SWITZER DRIVE SUITE 404
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City | BILOXI
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State | MS
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Zip | 39531
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Country | US
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Telephone | 228-575-2598
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Fax | 228-594-6744
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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 | PT0207
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License Number State | MS
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