Provider Demographics
NPI:1154909232
Name:ROSENBACH, SAMUEL T (DPT)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:T
Last Name:ROSENBACH
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ALDRIN RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4804
Mailing Address - Country:US
Mailing Address - Phone:508-728-8727
Mailing Address - Fax:305-595-8492
Practice Address - Street 1:16 ALDRIN RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4804
Practice Address - Country:US
Practice Address - Phone:508-728-8727
Practice Address - Fax:305-595-8492
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT36970225100000X
MAPT26182225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist