Provider Demographics
NPI:1801975016
Name:ROSSMAN, PAUL DANIEL (PT)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:DANIEL
Last Name:ROSSMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3970 N OAKLAND AVE
Mailing Address - Street 2:SUITE 703
Mailing Address - City:SHOREWOOD
Mailing Address - State:WI
Mailing Address - Zip Code:53211-2265
Mailing Address - Country:US
Mailing Address - Phone:414-963-6330
Mailing Address - Fax:414-963-6331
Practice Address - Street 1:3970 N OAKLAND AVE
Practice Address - Street 2:SUITE 703
Practice Address - City:SHOREWOOD
Practice Address - State:WI
Practice Address - Zip Code:53211-2265
Practice Address - Country:US
Practice Address - Phone:414-963-6330
Practice Address - Fax:414-963-6331
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40304800Medicaid
WI000086442Medicare ID - Type Unspecified