Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 62 040448 | NY |
N | 2251C2600X | Cardiopulmonary | 62 040448 | NY |
N | 2251G0304X | Physical Therapist - Geriatrics | 62 040448 | NY |
N | 2251S0007X | Physical Therapist - Sports | 62 040448 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 62 040448 | NY |
NPI | 1538613351 |
---|---|
Provider Name | Breanne Rauscher |
First Address | Rochester, NY 14623-1447 |
Second Address | Salisbury, NC 28144-2515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2016 |
Last Update Date | 15/03/2017 |