Provider Demographics
NPI:1144464074
Name:ROSEWORKS INC
Entity type:Organization
Organization Name:ROSEWORKS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMARA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:601-898-9330
Mailing Address - Street 1:111 COLONY CROSSING WAY
Mailing Address - Street 2:SUITE 250
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7778
Mailing Address - Country:US
Mailing Address - Phone:601-898-9330
Mailing Address - Fax:601-437-3414
Practice Address - Street 1:111 COLONY CROSSING WAY
Practice Address - Street 2:SUITE 250
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-7778
Practice Address - Country:US
Practice Address - Phone:601-898-9330
Practice Address - Fax:601-437-3414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2081S0010X
MS453261QP2000X, 173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173C00000XOther Service ProvidersReflexologistGroup - Multi-Specialty
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty