Healthcare Provider Details

I. General information

NPI: 1114338456
Provider Name (Legal Business Name): RHONDA LYNN DEROSIER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RHONDA MICHELS

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CORPORATE CENTER CURV
SAINT PAUL MN
55121-1373
US

IV. Provider business mailing address

1400 CORPORATE CENTER CURV
EAGAN MN
55121-1373
US

V. Phone/Fax

Practice location:
  • Phone: 651-968-5719
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA637
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: