Provider Demographics
NPI:1669526067
Name:ROGERS, CHRISTINE (PT)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:ROGERS
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:PO BOX 62183
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96839-2183
Mailing Address - Country:US
Mailing Address - Phone:808-942-8922
Mailing Address - Fax:808-942-8922
Practice Address - Street 1:460 ENA RD
Practice Address - Street 2:607
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1779
Practice Address - Country:US
Practice Address - Phone:808-942-8922
Practice Address - Fax:808-942-8922
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT995225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI100399Medicare ID - Type Unspecified