Provider Demographics
NPI:1730427956
Name:ROGERS, MICHAEL DENNIS (PT)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:DENNIS
Last Name:ROGERS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2781 CT SWITZER DRIVE
Mailing Address - Street 2:SUITE 404
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531
Mailing Address - Country:US
Mailing Address - Phone:228-575-2598
Mailing Address - Fax:228-594-6744
Practice Address - Street 1:3680 SANGANI BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-8703
Practice Address - Country:US
Practice Address - Phone:601-714-0315
Practice Address - Fax:601-714-0316
Is Sole Proprietor?:No
Enumeration Date:2013-01-23
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSPT0207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist