Provider Demographics
NPI:1306117783
Name:WRONA, ROSEMARY (PT)
Entity type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:
Last Name:WRONA
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 1:2 LODGE LN
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-1629
Mailing Address - Country:US
Mailing Address - Phone:413-596-5362
Mailing Address - Fax:413-596-5367
Practice Address - Street 1:2 LODGE LN
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095
Practice Address - Country:US
Practice Address - Phone:413-596-5362
Practice Address - Fax:413-596-5367
Is Sole Proprietor?:No
Enumeration Date:2012-01-18
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005386225100000X
MA19436225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist