Healthcare Provider Details

I. General information

NPI: 1124158332
Provider Name (Legal Business Name): JESSICA SELF ROSNER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CARRINGTON LN STE C
CALERA AL
35040-5439
US

IV. Provider business mailing address

101 CARRINGTON LN STE C
CALERA AL
35040-5439
US

V. Phone/Fax

Practice location:
  • Phone: 205-621-3077
  • Fax: 205-621-3788
Mailing address:
  • Phone: 205-621-3077
  • Fax: 205-621-3788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH4956
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: