Provider Demographics
NPI:1043668957
Name:ROSSMAN, MATTHEW (DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:
Last Name:ROSSMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:17332 VON KARMAN AVE
Mailing Address - Street 2:STE 120
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6282
Mailing Address - Country:US
Mailing Address - Phone:949-861-8600
Mailing Address - Fax:949-861-8601
Practice Address - Street 1:1635 N GEORGE MASON DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205-3601
Practice Address - Country:US
Practice Address - Phone:703-810-5216
Practice Address - Fax:703-810-5494
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT43146225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist