Provider Demographics
NPI:1245391499
Name:RODGERS, SHEILA (PT)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:RODGERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 CHARLIE PENNY RD
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:AL
Mailing Address - Zip Code:36272-6824
Mailing Address - Country:US
Mailing Address - Phone:256-435-7313
Mailing Address - Fax:
Practice Address - Street 1:409 E 10TH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4780
Practice Address - Country:US
Practice Address - Phone:256-238-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH1748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALPTH1748OtherPHYSICAL THERAPY LICENSE