Provider Demographics
NPI:1679231708
Name:CONNOR, ROZ (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:DR
First Name:ROZ
Middle Name:
Last Name:CONNOR
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 COURT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81003-2872
Mailing Address - Country:US
Mailing Address - Phone:719-423-0187
Mailing Address - Fax:
Practice Address - Street 1:1005 COURT ST STE 2
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-2872
Practice Address - Country:US
Practice Address - Phone:719-423-0187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0010344225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist