Provider Demographics
NPI:1184896664
Name:LIU, ROSALYN JUO-LIEN (PT)
Entity type:Individual
Prefix:MS
First Name:ROSALYN
Middle Name:JUO-LIEN
Last Name:LIU
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 1:613 W LEMON AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-7949
Mailing Address - Country:US
Mailing Address - Phone:626-203-8665
Mailing Address - Fax:626-254-0235
Practice Address - Street 1:15 LAS TUNAS DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-8511
Practice Address - Country:US
Practice Address - Phone:626-447-9700
Practice Address - Fax:626-446-5405
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT21783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist