Provider Demographics
NPI:1558591859
Name:ROGERS, JESSICA LEIGH (DPT)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEIGH
Last Name:ROGERS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5067 SMITHS GROVE SCOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SMITHS GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:42171-9409
Mailing Address - Country:US
Mailing Address - Phone:317-902-8034
Mailing Address - Fax:
Practice Address - Street 1:5067 SMITHS GROVE SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:SMITHS GROVE
Practice Address - State:KY
Practice Address - Zip Code:42171-9409
Practice Address - Country:US
Practice Address - Phone:317-902-8034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-21
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006405225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist