Provider Demographics
NPI:1790025070
Name:ROSCOE OCCUPATIONAL HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:ROSCOE OCCUPATIONAL HEALTH SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LINK
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:815-568-8878
Mailing Address - Street 1:PO BOX 581
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-0581
Mailing Address - Country:US
Mailing Address - Phone:815-623-9700
Mailing Address - Fax:815-623-9722
Practice Address - Street 1:5003 HONONEGAH RD
Practice Address - Street 2:
Practice Address - City:ROSCOE
Practice Address - State:IL
Practice Address - Zip Code:61073-8645
Practice Address - Country:US
Practice Address - Phone:815-623-9700
Practice Address - Fax:815-623-9722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty