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Individual

MRS. BRIDGET ROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
600 W OWENS ST, CARBONDALE, IL 62901-1246
(618) 967-5186
Mailing address
600 W OWENS ST, CARBONDALE, IL 62901-1246
(618) 967-5186

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005138
IL

Other

Enumeration date
11/04/2015
Last updated
11/04/2015
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