Organization
JENNY ROSE SPECIALIZED THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE R PARKER CHT (DIRECTOR/OWNER)
(570) 421-3415
Entity
Organization
Contact information
Practice address
296 E BROWN ST, SUITE B, EAST STROUDSBURG, PA 18301-3011
(570) 421-3415
(570) 421-9873
Mailing address
296 E BROWN ST, SUITE B, EAST STROUDSBURG, PA 18301-3011
(570) 421-3415
(570) 421-9873
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC005819
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1018703100004
—
PA
05
—
1018703100005
—
PA
Enumeration date
11/29/2007
Last updated
08/07/2008
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