Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 40QA00996000 | NJ |
Y | 2251N0400X | Physical Therapist - Neurology | PT011000L | PA |
NPI | 1669534103 |
---|---|
Provider Name | Roseanne Rhodes |
First Address | Milford, PA 18337-9706 |
Second Address | Newton, NJ 07860-2769 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 15/05/2009 |