Provider Demographics
NPI:1255884516
Name:ROSANDICK, MARGUERITE (DPT)
Entity type:Individual
Prefix:
First Name:MARGUERITE
Middle Name:
Last Name:ROSANDICK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N2393 COUNTY RD W
Mailing Address - Street 2:
Mailing Address - City:GRANTON
Mailing Address - State:WI
Mailing Address - Zip Code:54436-8041
Mailing Address - Country:US
Mailing Address - Phone:715-305-7731
Mailing Address - Fax:
Practice Address - Street 1:N2393 COUNTY RD W
Practice Address - Street 2:
Practice Address - City:GRANTON
Practice Address - State:WI
Practice Address - Zip Code:54436-8041
Practice Address - Country:US
Practice Address - Phone:715-305-7731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist