Basic Information
| Provider Information | |||||||||
| NPI: | 1124299664 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROGERS | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | PT, DPT, ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 111 GOOSE LN | ||||||||
| Address2: | SUITE 2500 | ||||||||
| City: | GUILFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064375101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034530134 | ||||||||
| FaxNumber: | 2034530167 | ||||||||
| Practice Location | |||||||||
| Address1: | 111 GOOSE LN | ||||||||
| Address2: | SUITE 2500 | ||||||||
| City: | GUILFORD | ||||||||
| State: | CT | ||||||||
| PostalCode: | 064375101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2034530134 | ||||||||
| FaxNumber: | 2034530167 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2008 | ||||||||
| LastUpdateDate: | 03/12/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 008283 | CT | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.