Provider Demographics
NPI:1831360908
Name:ROZIC, JUDITH KAY (MPT)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:KAY
Last Name:ROZIC
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12820 BIG CREEK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-9811
Mailing Address - Country:US
Mailing Address - Phone:440-286-5456
Mailing Address - Fax:
Practice Address - Street 1:12820 BIG CREEK RIDGE DR
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-9811
Practice Address - Country:US
Practice Address - Phone:440-286-5456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH08818225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist