Provider Demographics
NPI:1972705309
Name:ROGERS, PATRICIA ALEXANDER (DPT)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ALEXANDER
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:1024 GANNETT RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1725
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:156 N BELVEDERE DR
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-5418
Practice Address - Country:US
Practice Address - Phone:615-451-1877
Practice Address - Fax:615-451-1878
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7838225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3731301Medicaid