Provider Demographics
NPI:1730899345
Name:ROSOLOWSKI, RACHEL MARIE (DPT PT)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:MARIE
Last Name:ROSOLOWSKI
Suffix:
Gender:F
Credentials:DPT PT
Other - Prefix:
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Mailing Address - Street 1:413 S JUANITA AVE
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-3825
Mailing Address - Country:US
Mailing Address - Phone:310-902-0537
Mailing Address - Fax:
Practice Address - Street 1:129 W WILSON ST STE 202
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-1586
Practice Address - Country:US
Practice Address - Phone:949-631-0125
Practice Address - Fax:949-631-0127
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA303243225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist