Provider Demographics
NPI:1083891014
Name:ROZINA AND SMITH PHYSICAL THERAPY
Entity type:Organization
Organization Name:ROZINA AND SMITH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ROZINA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:909-985-8686
Mailing Address - Street 1:846 W FOOTHILL BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786
Mailing Address - Country:US
Mailing Address - Phone:909-985-8686
Mailing Address - Fax:909-985-5706
Practice Address - Street 1:846 W FOOTHILL BLVD STE C
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786
Practice Address - Country:US
Practice Address - Phone:909-985-8686
Practice Address - Fax:909-985-5706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23469OtherPT LICENSE