Provider Demographics
NPI:1487804266
Name:O'GRADY, CORINNE ROSENBERGER (LPT)
Entity type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:ROSENBERGER
Last Name:O'GRADY
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6333
Mailing Address - Country:US
Mailing Address - Phone:610-565-3232
Mailing Address - Fax:610-565-2816
Practice Address - Street 1:115 S PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:PA
Practice Address - Zip Code:19086-6333
Practice Address - Country:US
Practice Address - Phone:610-565-3232
Practice Address - Fax:610-565-2816
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005347L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist