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General NPI Number Information
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NPI Number | 1689815896
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Entity Type | Individual
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Provider Name | ROSEMARIE DICKINSON
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Gender | Female
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Dates
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Enumeration Date | 03/18/2009
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 4100 MOORES LN
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City | TEXARKANA
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State | TX
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Zip | 75503-5102
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Country | US
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Telephone | 281-363-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 5707 SUMMERWOOD LANE
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City | TEXARKANA
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State | AR
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Zip | 71854
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1183518
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License Number State | TX
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