Basic Information
| Provider Information | |||||||||
| NPI: | 1497300784 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SOUSA | ||||||||
| FirstName: | ROCHELLE | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 655 NORTHERN BLVD | ||||||||
| Address2: | |||||||||
| City: | SOUTH ABINGTON TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184118740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708429323 | ||||||||
| FaxNumber: | 5708429362 | ||||||||
| Practice Location | |||||||||
| Address1: | 6455 CARLISLE PIKE STE 2 | ||||||||
| Address2: | |||||||||
| City: | MECHANICSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170502390 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178028767 | ||||||||
| FaxNumber: | 7177089453 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2019 | ||||||||
| LastUpdateDate: | 08/05/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT028044 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.