Provider Demographics
NPI:1114645322
Name:ROSE PELVIC PHYSIOTHERAPY LLC
Entity Type:Organization
Organization Name:ROSE PELVIC PHYSIOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHA'ROSE
Authorized Official - Middle Name:T
Authorized Official - Last Name:ERION
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:256-705-3525
Mailing Address - Street 1:224 CHURCH ST NW STE D
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5543
Mailing Address - Country:US
Mailing Address - Phone:256-705-3525
Mailing Address - Fax:256-669-0592
Practice Address - Street 1:224 CHURCH ST NW STE D
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5543
Practice Address - Country:US
Practice Address - Phone:256-705-3525
Practice Address - Fax:256-669-0592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty