Provider Demographics
NPI:1588086128
Name:ROGERS, CALEB (CO)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:ROGERS
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1352 MATTHEWS TOWNSHIP PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-4983
Mailing Address - Country:US
Mailing Address - Phone:704-841-4388
Mailing Address - Fax:704-849-7727
Practice Address - Street 1:1352 MATTHEWS TOWNSHIP PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4983
Practice Address - Country:US
Practice Address - Phone:704-841-4388
Practice Address - Fax:704-849-7727
Is Sole Proprietor?:No
Enumeration Date:2014-01-16
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist