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General NPI Number Information
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NPI Number | 1154642379
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Entity Type | Individual
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Provider Name | ROSEANNE AMAROSE L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2010
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Last Update Date | 06/22/2010
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Provider Practice Location Address
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Address Line | 6142 STATE HIGHWAY 12 SUITE 2
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City | NORWICH
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State | NY
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Zip | 13815-3536
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Country | US
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Telephone | 607-316-4903
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Fax |
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Provider Business Mailing Address
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Address Line | 115 E HINDS AVE
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City | SHERRILL
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State | NY
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Zip | 13461-1238
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number | 023650
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License Number State | NY
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