Provider Demographics
NPI:1649995960
Name:ROSSI, MICHAEL GIAN (MPT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GIAN
Last Name:ROSSI
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 S PALISADES DR
Mailing Address - Street 2:
Mailing Address - City:SIGNAL MOUNTAIN
Mailing Address - State:TN
Mailing Address - Zip Code:37377-2929
Mailing Address - Country:US
Mailing Address - Phone:909-636-2482
Mailing Address - Fax:
Practice Address - Street 1:506 S PALISADES DR
Practice Address - Street 2:
Practice Address - City:SIGNAL MOUNTAIN
Practice Address - State:TN
Practice Address - Zip Code:37377-2929
Practice Address - Country:US
Practice Address - Phone:909-636-2482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPT00000131802251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics