Provider Demographics
NPI:1174574131
Name:ROGERS, JENNIFER J (PHD, ATC, LAT)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:J
Last Name:ROGERS
Suffix:
Gender:F
Credentials:PHD, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S. GRAND AVE
Mailing Address - Street 2:E213B FH
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1839
Mailing Address - Country:US
Mailing Address - Phone:319-384-9770
Mailing Address - Fax:
Practice Address - Street 1:225 S. GRAND AVE
Practice Address - Street 2:E213B FH
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-5224
Practice Address - Country:US
Practice Address - Phone:319-384-9770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001602255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer