Individual
MR. JEFFREY R ROSAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1900 W STATE HIGHWAY 6, WACO, TX 76712-9729
(254) 776-9681
Mailing address
1900 W HWY 6, WACO, TX 76712
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
2101112
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
452639073
RELIANT REHAB
TX
Enumeration date
05/07/2019
Last updated
05/07/2019
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