Provider Demographics
NPI:1548911480
Name:ROSSIER, MACKENZIE (PT)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:ROSSIER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MACKENZIE
Other - Middle Name:
Other - Last Name:GRUBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1345 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5964
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1013 WEXFORD PLAZA DR
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9214
Practice Address - Country:US
Practice Address - Phone:724-934-2440
Practice Address - Fax:724-934-2442
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT030174225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist