Individual
JUAN ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
123 COUCH LN, EASLEY, SC 29642-1916
(786) 393-4869
Mailing address
202 PURCELL WAY, EASLEY, SC 29642-8430
(786) 393-4869
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7483
SC
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
7483
SC
225XP0200X
Pediatric Occupational Therapist
OT18640
FL
Other
Enumeration date
10/30/2017
Last updated
02/11/2026
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