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Individual

JOHN ROSSAKIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5708 42ND AVE S, MINNEAPOLIS, MN 55417
(612) 310-0422
Mailing address
5708 42ND AVE S, MINNEAPOLIS, MN 55417-3004

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101783
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101783
MN LICENSE
MN
01
1018256
NBCOT 1018256
Enumeration date
06/05/2015
Last updated
06/05/2015
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Product
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  • EDI platform