Provider Demographics
NPI:1104332014
Name:DOSS, ROSALINDA (PT)
Entity type:Individual
Prefix:
First Name:ROSALINDA
Middle Name:
Last Name:DOSS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9814 WHITE HILL CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-5982
Mailing Address - Country:US
Mailing Address - Phone:765-603-6979
Mailing Address - Fax:
Practice Address - Street 1:4180 SAGE BLUFF XING
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-2363
Practice Address - Country:US
Practice Address - Phone:260-443-7300
Practice Address - Fax:260-482-5005
Is Sole Proprietor?:No
Enumeration Date:2017-12-15
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010780A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist