Individual
JENNIFER ROST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1430
MT
225100000X
Physical Therapist
Primary
6942
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3402282
—
MT
05
—
500649849
—
OR
Enumeration date
05/23/2005
Last updated
11/15/2012
Update your record
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