Provider Demographics
NPI:1790818185
Name:ROSENKRANS, RUTH ANNETTE (PT)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANNETTE
Last Name:ROSENKRANS
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 1:5200 COUNTY ROAD 254
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:MO
Mailing Address - Zip Code:63461-3221
Mailing Address - Country:US
Mailing Address - Phone:573-822-4618
Mailing Address - Fax:
Practice Address - Street 1:5200 COUNTY ROAD 254
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:MO
Practice Address - Zip Code:63461-3221
Practice Address - Country:US
Practice Address - Phone:573-822-4618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01665225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist