Provider Demographics
NPI:1235809823
Name:ROGERS, HALEY KRISTINE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:HALEY
Middle Name:KRISTINE
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 BLACK RIDGE VW APT 307
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80924-4444
Mailing Address - Country:US
Mailing Address - Phone:919-323-7560
Mailing Address - Fax:
Practice Address - Street 1:506 GOLDEN ST STE 120
Practice Address - Street 2:
Practice Address - City:CALHAN
Practice Address - State:CO
Practice Address - Zip Code:80808-8727
Practice Address - Country:US
Practice Address - Phone:719-347-2399
Practice Address - Fax:719-471-4415
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0017936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist