Provider Demographics
NPI:1588827315
Name:ROGERS, REGINALD EUGENE (CRT)
Entity Type:Individual
Prefix:
First Name:REGINALD
Middle Name:EUGENE
Last Name:ROGERS
Suffix:
Gender:M
Credentials:CRT
Other - Prefix:
Other - First Name:REGINALD
Other - Middle Name:
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRT
Mailing Address - Street 1:300 CONHOCKEN CT
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-4781
Mailing Address - Country:US
Mailing Address - Phone:615-631-6385
Mailing Address - Fax:
Practice Address - Street 1:300 CONHOCKEN CT
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-4781
Practice Address - Country:US
Practice Address - Phone:615-631-6385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0998227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified