Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT022737 | PA |
NPI | 1003213794 |
---|---|
Provider Name | Karen Roda |
First Address | Pittsburgh, PA 15232-1304 |
Second Address | Pittsburgh, PA 15232-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/11/2014 |
Last Update Date | 25/11/2014 |