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NPI Code Detail

MEDICARE: ROSALINDA DOSS PT

MEDICARE: ROSALINDA DOSS PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist05010780AIN

General Provider Information

NPI Number : 1104332014
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSALINDA DOSS PT
Provider Business Mailing Address
First Line : 9814 WHITE HILL CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-5982
Country : US
Telephone Number : 765-603-6979
Fax Number :
Provider Business Practice Location Address
First Line : 4180 SAGE BLUFF XING
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-2363
Country : US
Telephone Number : 260-443-7300
Fax Number : 260-482-5005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2017
Last Update Date : 12/15/2017

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