Healthcare Provider Details

I. General information

NPI: 1568757995
Provider Name (Legal Business Name): MEREDITH ANN ROSCO D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MERI ANN ROSCO D.C.

II. Dates (important events)

Enumeration Date: 06/14/2011
Last Update Date: 12/09/2019
Certification Date: 12/09/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

173 RUSTWOOD LN
MOORESVILLE NC
28117-8030
US

IV. Provider business mailing address

20723 TORRENCE CHAPEL RD STE 201
CORNELIUS NC
28031-6399
US

V. Phone/Fax

Practice location:
  • Phone: 203-994-4541
  • Fax: 203-724-0383
Mailing address:
  • Phone: 704-895-2240
  • Fax: 704-765-4077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX012032
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4535
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number001884
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: