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NPI Code Detail

MEDICARE: TAYLOR LOUISE ROGERS

MEDICARE: TAYLOR LOUISE ROGERS
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
1225800000XRecreation Therapist14040764-4003UT

General Provider Information

NPI Number : 1649003260
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR LOUISE ROGERS
Provider Business Mailing Address
First Line : 3084 SOUTHCREEK DR
Second Line :
City : LINCOLN
State : CA
Zip : 95648-8286
Country : US
Telephone Number : 916-295-8022
Fax Number :
Provider Business Practice Location Address
First Line : 1480 N 400 E
Second Line :
City : LOGAN
State : UT
Zip : 84341-7525
Country : US
Telephone Number : 916-295-8022
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2024
Last Update Date : 08/20/2024

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Directions to “ TAYLOR LOUISE ROGERS ” Practice Location

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