Provider Demographics
NPI:1205575925
Name:ROGERS, WALTER F (DPT)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:F
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 1:229 JENKINS RANCH RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-9462
Mailing Address - Country:US
Mailing Address - Phone:315-436-8200
Mailing Address - Fax:315-218-7466
Practice Address - Street 1:229 JENKINS RANCH RD UNIT A
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-9462
Practice Address - Country:US
Practice Address - Phone:315-436-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0018090225100000X
NMPT6080225100000X
COPTL.0018090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist