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General NPI Number Information
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NPI Number | 1649946401
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Entity Type | Individual
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Provider Name | JOHN JOSEPH ROSELLI JR. DPT
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Gender | Male
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 4430 LAVON DR STE 340
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City | GARLAND
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State | TX
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Zip | 75040-2974
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Country | US
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Telephone | 972-495-5416
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Fax |
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Provider Business Mailing Address
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Address Line | 601 PATTON BLVD APT 406
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City | PLANO
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State | TX
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Zip | 75075-8975
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Country | US
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Telephone | 516-512-4887
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1352417
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License Number State | TX
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