MEDICARE: MS. CYNTHIA LYNNE ROGERS P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT-7444	OH

General Provider Information

NPI Number	:	1508829607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA LYNNE ROGERS P.T.

Provider Business Mailing Address
First Line	:	PO BOX 116
Second Line	:	64 JULIA STREET
City	:	GRAND RIVER
State	:	OH
Zip	:	44045-0116
Country	:	US
Telephone Number	:	440-352-7124
Fax Number	:

Provider Business Practice Location Address
First Line	:	6270 N RIDGE RD
Second Line	:
City	:	MADISON
State	:	OH
Zip	:	44057-2567
Country	:	US
Telephone Number	:	440-428-8242
Fax Number	:	440-428-8243

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2006
Last Update Date	:	07/08/2007

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