Provider Demographics
NPI:1699908863
Name:ROSEMAN, MATTHEW JOSEPH (DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JOSEPH
Last Name:ROSEMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91480 STEINMETZ RD
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97448-9540
Mailing Address - Country:US
Mailing Address - Phone:541-228-5132
Mailing Address - Fax:
Practice Address - Street 1:88267 TERRITORIAL RD STE 10A
Practice Address - Street 2:
Practice Address - City:VENETA
Practice Address - State:OR
Practice Address - Zip Code:97487-9499
Practice Address - Country:US
Practice Address - Phone:541-935-0761
Practice Address - Fax:541-935-0536
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6047225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist