Provider Demographics
NPI:1578221867
Name:CRESSMAN, ROSS MICHAEL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:MICHAEL
Last Name:CRESSMAN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ROSS
Other - Middle Name:MICHAEL
Other - Last Name:CRESSMAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:535 CENTERVILLE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-4376
Mailing Address - Country:US
Mailing Address - Phone:401-737-6011
Mailing Address - Fax:
Practice Address - Street 1:594 GREAT RD
Practice Address - Street 2:
Practice Address - City:N SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02896-6810
Practice Address - Country:US
Practice Address - Phone:401-597-5840
Practice Address - Fax:401-597-5842
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA25865225100000X
RIPT03456225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist