Individual
RYAN MICHAEL DEROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(608) 280-7036
(608) 280-7079
Mailing address
2500 OVERLOOK TER, MADISON, WI 53705-2254
(608) 280-7036
(608) 280-7079
Taxonomy
Speciality
Code
Description
License number
State
283X00000X
Rehabilitation Hospital
Primary
12121-24
WI
Other
Enumeration date
12/26/2012
Last updated
12/26/2012
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