Healthcare Provider Details

I. General information

NPI: 1710106406
Provider Name (Legal Business Name): ALLAN JOSEPH ROSENBAUM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 09/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N WALNUT ST
MUENSTER TX
76252-2766
US

IV. Provider business mailing address

208 N WALNUT ST
MUENSTER TX
76252-2766
US

V. Phone/Fax

Practice location:
  • Phone: 940-759-2005
  • Fax: 940-759-2006
Mailing address:
  • Phone: 940-759-2005
  • Fax: 940-759-2006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4294
License Number StateTX

VIII. Authorized Official

Name: ALLAN JOSEPH ROSENBAUM
Title or Position: PROPRIETOR
Credential: D.C.
Phone: 940-759-2005