Provider Demographics
NPI:1952601346
Name:ROSENKRANS PHYSICAL THERAPY
Entity Type:Organization
Organization Name:ROSENKRANS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSENKRANS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:941-799-9317
Mailing Address - Street 1:4829 14TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-5880
Mailing Address - Country:US
Mailing Address - Phone:941-799-9317
Mailing Address - Fax:941-753-6821
Practice Address - Street 1:6016 MANATEE AVE W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-2417
Practice Address - Country:US
Practice Address - Phone:941-799-9317
Practice Address - Fax:941-753-6821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT24652225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty