Most Relevant Information
Provider Data
| NPI Number: | 1003482852 |
| Provider Name: | SHANNON ROGERS PTA |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: | 2306605719 |
Most Important Dates
| Enumeration Date: | 06/02/2021 |
| Last Updated: | 06/02/2021 |
Provider Practice Location
219 WEAVER AVE
EMPORIA
VA
238471248
Practice Location Phone/Fax
| Phone: | 4343365300 |
| Fax: | 4343365301 |
Provider Mailing Location
219 WEAVER AVE
EMPORIA
VA
238471248
Provider Mailing Phone/Fax
| Phone: | 4343365300 |
| Fax: | 4343365301 |