Provider Demographics
NPI:1396296257
Name:ROGERSVILLE PHYSICAL THERAPY, LLC
Entity type:Organization
Organization Name:ROGERSVILLE PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATT
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOOTER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:417-827-5878
Mailing Address - Street 1:427 S MILL ST
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65742-7601
Mailing Address - Country:US
Mailing Address - Phone:417-753-7735
Mailing Address - Fax:417-753-7765
Practice Address - Street 1:427 S MILL ST
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65742-7601
Practice Address - Country:US
Practice Address - Phone:417-753-7735
Practice Address - Fax:417-753-7765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy