Provider Demographics
NPI:1235247016
Name:RODGERS, VANESSA RHEA (LMT, MMP)
Entity Type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:RHEA
Last Name:RODGERS
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9555 COLONIAL HILLS CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-7414
Mailing Address - Country:US
Mailing Address - Phone:251-404-8063
Mailing Address - Fax:
Practice Address - Street 1:3263 DEMETROPOLIS RD
Practice Address - Street 2:SUITE 10
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-4638
Practice Address - Country:US
Practice Address - Phone:251-404-8063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2181174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist