Provider Demographics
NPI:1972873743
Name:FRANCES ROGGEN, P.T., P.A.
Entity type:Organization
Organization Name:FRANCES ROGGEN, P.T., P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:CRONSTEIN
Authorized Official - Last Name:ROGGEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:410-979-6143
Mailing Address - Street 1:PO BOX 888
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINAIR
Mailing Address - State:NM
Mailing Address - Zip Code:87036-0888
Mailing Address - Country:US
Mailing Address - Phone:410-979-6143
Mailing Address - Fax:
Practice Address - Street 1:121 RTE 60
Practice Address - Street 2:
Practice Address - City:MOUNTAINAIR
Practice Address - State:NM
Practice Address - Zip Code:87036
Practice Address - Country:US
Practice Address - Phone:410-979-6143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-10
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
121RMedicare PIN