Basic Information
| Provider Information | |||||||||
| NPI: | 1962658849 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROGOWSKI | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 112 LAUREL ST. | ||||||||
| Address2: | |||||||||
| City: | LAPORTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463502658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2195750506 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9935 RED ARROW HWY | ||||||||
| Address2: | |||||||||
| City: | BRIDGMAN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 491069002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2694653017 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2008 | ||||||||
| LastUpdateDate: | 08/12/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.