Individual
JOSE DELAROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
290 OAK RD, BANGOR, PA 18013-2718
(610) 790-3644
Mailing address
290 OAK RD, BANGOR, PA 18013-2718
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
T800II
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
T80011
PHYSICAL THERAPY
PA
Enumeration date
09/28/2021
Last updated
09/28/2021
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