Provider Demographics
NPI:1942979729
Name:ROUS, MONICA PISZCZOR (DPT)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:PISZCZOR
Last Name:ROUS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MONICA
Other - Middle Name:LEAH
Other - Last Name:PISZCZOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 306393
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6393
Mailing Address - Country:US
Mailing Address - Phone:615-373-1350
Mailing Address - Fax:615-373-7116
Practice Address - Street 1:11201 GALLERIA AVE STE 105
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-8137
Practice Address - Country:US
Practice Address - Phone:919-670-3350
Practice Address - Fax:919-670-3351
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20691225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist