Provider Demographics
NPI:1932141314
Name:ROSSO, ERIN KRISTEN (PT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KRISTEN
Last Name:ROSSO
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 1:806 ANN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-8614
Mailing Address - Country:US
Mailing Address - Phone:303-949-6453
Mailing Address - Fax:
Practice Address - Street 1:2806 SAINT MARYS RD
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-4559
Practice Address - Country:US
Practice Address - Phone:303-949-6453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015825225100000X
CA35255225100000X
CO8295225100000X
FL37027225100000X
GA007502225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist