Basic Information
| Provider Information | |||||||||
| NPI: | 1932670551 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSENBERRY | ||||||||
| FirstName: | STACY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 CLAREMONT RD | ||||||||
| Address2: | |||||||||
| City: | CARLISLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170137310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172432031 | ||||||||
| FaxNumber: | 8552328604 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 CLAREMONT RD | ||||||||
| Address2: | |||||||||
| City: | CARLISLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170137310 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172432031 | ||||||||
| FaxNumber: | 8552328604 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/07/2018 | ||||||||
| LastUpdateDate: | 12/07/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | TEI000183 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.