Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 1209 | AZ |
NPI | 1750510137 |
---|---|
Provider Name | Dr. Pamela Rogers Bosch |
First Address | Mesa, AZ 85206-3618 |
Second Address | Mesa, AZ 85206-3618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2009 |
Last Update Date | 07/07/2009 |