Provider Demographics
NPI:1376215954
Name:ROSKE, KATHRYN ANN (PT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:ROSKE
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 1:1411 HIGHWAY 389
Mailing Address - Street 2:OPTIONAL
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759
Mailing Address - Country:US
Mailing Address - Phone:662-769-4888
Mailing Address - Fax:
Practice Address - Street 1:306 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-1935
Practice Address - Country:US
Practice Address - Phone:662-769-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist