Provider Demographics
NPI:1306438353
Name:ROGERS, MARCUS Q (DPTS)
Entity type:Individual
Prefix:
First Name:MARCUS
Middle Name:Q
Last Name:ROGERS
Suffix:
Gender:M
Credentials:DPTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 EAST GRAND RIVER
Mailing Address - Street 2:PO BOX 323
Mailing Address - City:FOWLERVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48836
Mailing Address - Country:US
Mailing Address - Phone:517-223-8308
Mailing Address - Fax:517-223-8344
Practice Address - Street 1:2810 W GRAND RIVER AVE STE 100
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8200
Practice Address - Country:US
Practice Address - Phone:517-223-8308
Practice Address - Fax:517-223-8344
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist