MEDICARE: ALISSON ROSENBLUM 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
1	225100000X	Physical Therapist	1543	RI

General Provider Information

NPI Number	:	1669683603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISSON ROSENBLUM PT

Provider Business Mailing Address
First Line	:	28 CHANDLER DR
Second Line	:
City	:	COVENTRY
State	:	RI
Zip	:	02816-8502
Country	:	US
Telephone Number	:	401-615-0304
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 TEN ROD RD
Second Line	:	LAFAYETTE MILL COMPLEX, #10
City	:	NORTH KINGSTOWN
State	:	RI
Zip	:	02852-4238
Country	:	US
Telephone Number	:	401-787-3476
Fax Number	:

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

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/08/2007

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Directions to “ ALISSON ROSENBLUM PT” Practice Location

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