Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 014373 | OH |
NPI | 1144655549 |
---|---|
Provider Name | Alexis J Roseman |
First Address | Cincinnati, OH 45221-0001 |
Second Address | Cincinnati, OH 45221-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2013 |
Last Update Date | 05/09/2013 |