Individual
GREGORY ERIC ROSEQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, SCS, ATC
Contact information
Practice address
22 WALMART PLZ, CLINTON, NJ 08809-1263
(908) 847-5210
Mailing address
30 THE CRES APT 1, MONTCLAIR, NJ 07042-2649
(973) 229-6075
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01463600
NJ
Other
Enumeration date
01/15/2018
Last updated
01/15/2018
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