Provider Demographics
NPI:1801997887
Name:ROSSON, LORI M (MPT)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:M
Last Name:ROSSON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:M
Other - Last Name:HOSSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9500 MICRON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2618
Mailing Address - Country:US
Mailing Address - Phone:916-362-7962
Mailing Address - Fax:
Practice Address - Street 1:9500 MICRON AVE STE 100
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2618
Practice Address - Country:US
Practice Address - Phone:916-362-7962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22605225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist