Provider Demographics
NPI:1083242929
Name:ROGERS, TORY (CTRS, CDP, CMDCP)
Entity type:Individual
Prefix:
First Name:TORY
Middle Name:
Last Name:ROGERS
Suffix:
Gender:F
Credentials:CTRS, CDP, CMDCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10305 HOPKINS RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1118
Mailing Address - Country:US
Mailing Address - Phone:804-690-9781
Mailing Address - Fax:
Practice Address - Street 1:10305 HOPKINS RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1118
Practice Address - Country:US
Practice Address - Phone:804-690-9781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty