Provider Demographics
NPI:1578254256
Name:ROGERS, TYLER (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TYLER
Middle Name:
Last Name:ROGERS
Suffix:
Gender:
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 15TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:SPIRIT LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:51360-1630
Mailing Address - Country:US
Mailing Address - Phone:319-759-6620
Mailing Address - Fax:
Practice Address - Street 1:2280 PEORIA AVENUE
Practice Address - Street 2:
Practice Address - City:SPIRIT LAKE
Practice Address - State:IA
Practice Address - Zip Code:51360
Practice Address - Country:US
Practice Address - Phone:712-320-0832
Practice Address - Fax:712-248-8626
Is Sole Proprietor?:No
Enumeration Date:2023-05-15
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist