Provider Demographics
NPI:1871197053
Name:KIRKPATRICK, ROSALIND (PTA)
Entity Type:Individual
Prefix:
First Name:ROSALIND
Middle Name:
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:GROVELAND
Mailing Address - State:MA
Mailing Address - Zip Code:01834-1048
Mailing Address - Country:US
Mailing Address - Phone:405-434-9975
Mailing Address - Fax:
Practice Address - Street 1:168 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:MA
Practice Address - Zip Code:01834-1048
Practice Address - Country:US
Practice Address - Phone:405-434-9975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9812225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant