MEDICARE: ROCHELLE SOUSA DPT

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
1	225100000X	Physical Therapist	PT028044	PA

General Provider Information

NPI Number	:	1497300784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROCHELLE SOUSA DPT

Provider Business Mailing Address
First Line	:	655 NORTHERN BLVD
Second Line	:
City	:	SOUTH ABINGTON TOWNSHIP
State	:	PA
Zip	:	18411-8740
Country	:	US
Telephone Number	:	570-842-9323
Fax Number	:	570-842-9362

Provider Business Practice Location Address
First Line	:	6455 CARLISLE PIKE STE 2
Second Line	:
City	:	MECHANICSBURG
State	:	PA
Zip	:	17050-2390
Country	:	US
Telephone Number	:	717-802-8767
Fax Number	:	717-708-9453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2019
Last Update Date	:	08/05/2019

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Directions to “ ROCHELLE SOUSA DPT” Practice Location

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