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Individual
TYSON ERIC ROSE
Active
Individual
TYSON ERIC ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT, SCS, LAT, ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT-11753
NC
225100000X
Physical Therapist
Primary
PT016099
PA
2255A2300X
Athletic Trainer
AT-1530
NC
2255A2300X
Athletic Trainer
RT003279
PA
Other
Enumeration date
11/18/2008
Last updated
06/05/2025
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