Provider Demographics
NPI:1356746341
Name:ROSSEWEY, THOMAS (LMT, PTA)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:ROSSEWEY
Suffix:
Gender:M
Credentials:LMT, PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 W BAY DR
Mailing Address - Street 2:SUITE 121
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3362
Mailing Address - Country:US
Mailing Address - Phone:727-424-2861
Mailing Address - Fax:
Practice Address - Street 1:118 W BAY DR
Practice Address - Street 2:SUITE 121
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-3362
Practice Address - Country:US
Practice Address - Phone:727-424-2861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-03
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA23653225200000X
FLMA50835225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant