Provider Demographics
NPI:1437524048
Name:ROCKSTROH, JUSTINA
Entity Type:Individual
Prefix:
First Name:JUSTINA
Middle Name:
Last Name:ROCKSTROH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 TOWNE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-4441
Mailing Address - Country:US
Mailing Address - Phone:410-679-1481
Mailing Address - Fax:
Practice Address - Street 1:1120 SAINT PAUL ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2618
Practice Address - Country:US
Practice Address - Phone:410-685-7790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2093225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant