Provider Demographics
NPI:1760046312
Name:ROGERS, JOSH (LPTA)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:
Last Name:ROGERS
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1452 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:RAINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35986-4327
Mailing Address - Country:US
Mailing Address - Phone:256-996-6118
Mailing Address - Fax:
Practice Address - Street 1:1452 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:RAINSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35986-4327
Practice Address - Country:US
Practice Address - Phone:256-996-6118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-30
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTA59772081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine