Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5501007051 | MI |
N | 2251G0304X | Physical Therapist - Geriatrics | 5501007051 | MI |
N | 2251N0400X | Physical Therapist - Neurology | 5501007051 | MI |
N | 2251X0800X | Physical Therapist - Orthopedic | 5501007051 | MI |
NPI | 1528506573 |
---|---|
Provider Name | Rosemarie Green |
First Address | Rochester, MI 48307-6037 |
Second Address | Clinton Twp, MI 48038-3504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2017 |
Last Update Date | 22/04/2021 |