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NPI Code Detail

MEDICARE: ERIN ROSE GINSBURG PTA

MEDICARE:   ERIN ROSE GINSBURG  PTA
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
1225200000XPhysical Therapy Assistant9583AAZ

General Provider Information

NPI Number : 1679840573
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN ROSE GINSBURG PTA
Provider Business Mailing Address
First Line : 1600 KIOWA AVE
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-2829
Country : US
Telephone Number : 702-513-4229
Fax Number :
Provider Business Practice Location Address
First Line : 2781 OSBORN DR
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86406-8629
Country : US
Telephone Number : 928-505-5552
Fax Number : 928-505-2660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2011
Last Update Date : 11/20/2011

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