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General NPI Number Information
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NPI Number | 1699230029
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Entity Type | Individual
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Provider Name | MATTHEW ROSSER OTD, ORT/L, LAT, ATC
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Gender | Male
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Dates
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Enumeration Date | 02/11/2019
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 7117 ORCHARD CENTRE DR
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City | HOLLAND
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State | OH
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Zip | 43528-7974
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Country | US
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Telephone | 567-297-2050
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Fax |
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Provider Business Mailing Address
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Address Line | 2122 YORK RD STE 300
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City | OAK BROOK
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State | IL
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Zip | 60523-1925
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Country | US
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Telephone | 630-575-1980
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 36003202A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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