Provider Demographics
NPI:1639962046
Name:ROSSER, BETHANY ROSE (DPT)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:ROSE
Last Name:ROSSER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 SCHILLINGER RD S APT 1411
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-8992
Mailing Address - Country:US
Mailing Address - Phone:423-646-0160
Mailing Address - Fax:
Practice Address - Street 1:25620 FRIENDSHIP RD
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-6022
Practice Address - Country:US
Practice Address - Phone:251-270-1551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH12310225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist