Provider Demographics
NPI:1093961203
Name:EARHART, ROSEANN SCIACCA (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROSEANN
Middle Name:SCIACCA
Last Name:EARHART
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 1:6 CEDAR FIELD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-2810
Mailing Address - Country:US
Mailing Address - Phone:803-407-0208
Mailing Address - Fax:
Practice Address - Street 1:6 CEDAR FIELD CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-2810
Practice Address - Country:US
Practice Address - Phone:803-407-0208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2304225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist