Provider Demographics
NPI:1669534103
Name:RHODES, ROSEANNE (PT)
Entity type:Individual
Prefix:
First Name:ROSEANNE
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4136 CONASHAUGH LK
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-9706
Mailing Address - Country:US
Mailing Address - Phone:570-686-3248
Mailing Address - Fax:973-383-3907
Practice Address - Street 1:125 NEWTON SPARTA RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2769
Practice Address - Country:US
Practice Address - Phone:973-383-4180
Practice Address - Fax:973-383-3907
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2009-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA009960002251N0400X
PAPT011000L2251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology