Provider Demographics
NPI:1326929472
Name:ROGERS, COLE A (DPT)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:A
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13690 HIGHWAY 51 S STE 104
Mailing Address - Street 2:
Mailing Address - City:ATOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38004-7645
Mailing Address - Country:US
Mailing Address - Phone:901-259-4254
Mailing Address - Fax:901-725-8353
Practice Address - Street 1:13690 HIGHWAY 51 S STE 104
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:TN
Practice Address - Zip Code:38004-7645
Practice Address - Country:US
Practice Address - Phone:901-259-4254
Practice Address - Fax:901-725-8353
Is Sole Proprietor?:No
Enumeration Date:2025-09-08
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16835225100000X
NY055013-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist