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Individual

EMMANUEL ROSANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICAL THERAPIST

Contact information

Practice address
3401 SOLDIERS HOME RD., WEST LAFAYETTE, IN 47906-1222
(765) 463-1541
(765) 497-0687
Mailing address
5325 DUNBAR DR, LAFAYETTE, IN 47905-7577
(765) 463-1541
(765) 497-0687

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05004143A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000243263
ANTHEM PROVIDER #
IN
Enumeration date
04/26/2007
Last updated
07/08/2007
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