MEDICARE: PAUL D. ROSSMAN PTSC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	3947-024	WI

General Provider Information

NPI Number	:	1700950961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL D. ROSSMAN PTSC

Provider Business Mailing Address
First Line	:	3970 N OAKLAND AVE
Second Line	:	703
City	:	SHOREWOOD
State	:	WI
Zip	:	53211-2265
Country	:	US
Telephone Number	:	414-963-6330
Fax Number	:	414-963-6331

Provider Business Practice Location Address
First Line	:	3970 N OAKLAND AVE
Second Line	:	703
City	:	SHOREWOOD
State	:	WI
Zip	:	53211-2265
Country	:	US
Telephone Number	:	414-963-6330
Fax Number	:	414-963-6331

Authorized Official
Title or Position	:	OWNER
Name	:	PAUL D ROSSMAN
Credential	:	PT
Telephone Number	:	414-963-6330

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	08/22/2020

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