Provider Demographics
NPI:1588707186
Name:ROSENTHAL, TERRANCE CHRISTOPHER (AT, C)
Entity type:Individual
Prefix:MR
First Name:TERRANCE
Middle Name:CHRISTOPHER
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:AT, C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 N 20TH ST
Mailing Address - Street 2:#18
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5449
Mailing Address - Country:US
Mailing Address - Phone:334-749-8303
Mailing Address - Fax:334-745-5243
Practice Address - Street 1:121 N 20TH ST
Practice Address - Street 2:#18
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5449
Practice Address - Country:US
Practice Address - Phone:334-749-8303
Practice Address - Fax:334-745-5243
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4082255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer