Provider Demographics
NPI:1366876369
Name:ROGOWSKI, ERIN E (DPT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:E
Last Name:ROGOWSKI
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:E
Other - Last Name:HAKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5179 OLD WAGON RD
Mailing Address - Street 2:
Mailing Address - City:DELTA
Mailing Address - State:CO
Mailing Address - Zip Code:81416-3577
Mailing Address - Country:US
Mailing Address - Phone:970-399-9335
Mailing Address - Fax:
Practice Address - Street 1:5179 OLD WAGON RD
Practice Address - Street 2:
Practice Address - City:DELTA
Practice Address - State:CO
Practice Address - Zip Code:81416-3577
Practice Address - Country:US
Practice Address - Phone:970-399-9335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0015508225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist