Provider Demographics
NPI:1598908261
Name:RODGERS, LOIS M (PT)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:M
Last Name:RODGERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:LOIS
Other - Middle Name:M
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1005 S US HIGHWAY 27
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT JOHNS
Mailing Address - State:MI
Mailing Address - Zip Code:48879-2423
Mailing Address - Country:US
Mailing Address - Phone:989-224-3000
Mailing Address - Fax:989-224-1424
Practice Address - Street 1:1005 S US HIGHWAY 27
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-2423
Practice Address - Country:US
Practice Address - Phone:989-224-3000
Practice Address - Fax:989-224-1424
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010231225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist