NPI 1003289620

Bridget Rose, PTA

Practitioner Physical Therapy Assistant Carbondale, IL

Practice location

Address: 600 W Owens St, Carbondale, IL 62901-1246
Phone: (618) 967-5186

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 160005138 (IL)

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Registry record

NPI: 1003289620
Entity type: Individual
Sex (as registered): Female
NPI issued: 4 Nov 2015
Record last updated: 4 Nov 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.