# JENNY ROSE SPECIALIZED THERAPY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720260904
- **Authorized official:** ELAINE R PARKER CHT (DIRECTOR/OWNER)
- **Authorized official phone:** (570) 421-3415

## Contact information

- **Practice address:** 296 E BROWN ST, SUITE B, EAST STROUDSBURG, PA 18301-3011
- **Practice address phone:** (570) 421-3415
- **Practice address fax:** (570) 421-9873
- **Mailing address:** 296 E BROWN ST, SUITE B, EAST STROUDSBURG, PA 18301-3011
- **Mailing address phone:** (570) 421-3415
- **Mailing address fax:** (570) 421-9873

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | SC005819 | PA | Yes |

## Other

- **Enumeration date:** 11/29/2007
- **Last updated:** 08/07/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1018703100004 | — | PA |
| 05 | — | 1018703100005 | — | PA |