Healthcare Provider Details

I. General information

NPI: 1255327961
Provider Name (Legal Business Name): ROSEMARIE ANN SCOTTT D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 06/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

935 N VAN BUREN ST SUITE 2
SHIPSHEWANA IN
46565-8702
US

IV. Provider business mailing address

5880 N 175 W
HOWE IN
46746-9404
US

V. Phone/Fax

Practice location:
  • Phone: 260-768-4061
  • Fax:
Mailing address:
  • Phone: 260-768-4324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08000843A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberL557711
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: