MEDICARE: MR. BRIAN ROSNICK

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	225200000X	Physical Therapy Assistant	A3790	MD

General Provider Information

NPI Number	:	1679974216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN ROSNICK

Provider Business Mailing Address
First Line	:	3133 W SPRINGS DR
Second Line	:	APT. B
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-2947
Country	:	US
Telephone Number	:	727-773-5847
Fax Number	:

Provider Business Practice Location Address
First Line	:	3133 W SPRINGS DR
Second Line	:	APT. B
City	:	ELLICOTT CITY
State	:	MD
Zip	:	21043-2947
Country	:	US
Telephone Number	:	727-773-5847
Fax Number	:

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

Provider Enumeration Date	:	09/15/2014
Last Update Date	:	09/15/2014

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Directions to “ MR. BRIAN ROSNICK ” Practice Location

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