Individual
KENNEDY ROSE DIERCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
700 SUN GROVE TRL, GEORGETOWN, TX 78628-3737
(949) 212-3650
Mailing address
700 SUN GROVE TRL, GEORGETOWN, TX 78628-3737
(949) 212-3650
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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