Provider Demographics
NPI:1871774588
Name:ROGERS, LIANNE KA'UILANI (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:LIANNE
Middle Name:KA'UILANI
Last Name:ROGERS
Suffix:
Gender:F
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 1:2217 W KEATING AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-7321
Mailing Address - Country:US
Mailing Address - Phone:480-216-0019
Mailing Address - Fax:
Practice Address - Street 1:2217 W KEATING AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-7321
Practice Address - Country:US
Practice Address - Phone:480-216-0019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ79042251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic