Provider Demographics
NPI:1194966531
Name:ROSATO, DEANNA MARIE (MS, ATC)
Entity type:Individual
Prefix:MISS
First Name:DEANNA
Middle Name:MARIE
Last Name:ROSATO
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:SC
Mailing Address - Zip Code:29320-0427
Mailing Address - Country:US
Mailing Address - Phone:864-503-5060
Mailing Address - Fax:
Practice Address - Street 1:800 UNIVERSITY WAY
Practice Address - Street 2:ATHLETIC TRAINING
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4932
Practice Address - Country:US
Practice Address - Phone:864-503-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10482255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer