Provider Demographics
NPI:1912275595
Name:ROSE PHYSCIAL THERAPY GROUP
Entity type:Organization
Organization Name:ROSE PHYSCIAL THERAPY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:LAURA
Authorized Official - Last Name:BOWE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:202-630-0378
Mailing Address - Street 1:1000 NEW JERSEY AVE SE APT 326
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3352
Mailing Address - Country:US
Mailing Address - Phone:202-630-0378
Mailing Address - Fax:
Practice Address - Street 1:1101 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-4303
Practice Address - Country:US
Practice Address - Phone:503-680-3849
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2013-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPT871201261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy