Provider Demographics
NPI:1134813462
Name:HENZEL, ROSALYN (PT, DPT)
Entity type:Individual
Prefix:
First Name:ROSALYN
Middle Name:
Last Name:HENZEL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 EAGLE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-1770
Mailing Address - Country:US
Mailing Address - Phone:814-615-8943
Mailing Address - Fax:
Practice Address - Street 1:4055 MONROEVILLE BLVD
Practice Address - Street 2:BUILDING 1, SUITE 200
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2522
Practice Address - Country:US
Practice Address - Phone:412-692-9423
Practice Address - Fax:412-692-9420
Is Sole Proprietor?:No
Enumeration Date:2023-06-08
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT031274225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist