Individual
ANTOINETTE DEROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2405 FORT EUSTIS BLVD, YORKTOWN, VA 23692-4163
(757) 898-3746
Mailing address
121 LEEDS, WILLIAMSBURG, VA 23188-9184
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305006027
VA
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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