Healthcare Provider Details

I. General information

NPI: 1043544406
Provider Name (Legal Business Name): NATHAN ALAN ROSEL D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14111 WHITE CREEK AVE NE STE J
CEDAR SPRINGS MI
49319-8169
US

IV. Provider business mailing address

14111 WHITE CREEK AVE NE STE J
CEDAR SPRINGS MI
49319-8169
US

V. Phone/Fax

Practice location:
  • Phone: 616-256-8664
  • Fax:
Mailing address:
  • Phone: 616-256-8664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501014795
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: