Provider Demographics
NPI:1417127762
Name:TRACI L ROGERS PHYSICAL THERAPY, P. C.
Entity Type:Organization
Organization Name:TRACI L ROGERS PHYSICAL THERAPY, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:FALBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-836-8222
Mailing Address - Street 1:2105 SPRING RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47111-7807
Mailing Address - Country:US
Mailing Address - Phone:502-836-8222
Mailing Address - Fax:812-796-0116
Practice Address - Street 1:2105 SPRING RIDGE CT
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:IN
Practice Address - Zip Code:47111-7807
Practice Address - Country:US
Practice Address - Phone:502-836-8222
Practice Address - Fax:812-796-0116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty