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General NPI Number Information
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NPI Number | 1215263108
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Entity Type | Organization
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Legal Business Name | ROSE CHIROPRACTIC, PC
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Dates
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Enumeration Date | 10/27/2009
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Last Update Date | 10/27/2009
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Provider Practice Location Address
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Address Line | 34024 W 8 MILE RD SUITE 104
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-5209
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Country | US
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Telephone | 248-888-8183
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Fax |
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Provider Business Mailing Address
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Address Line | 34024 W 8 MILE RD SUITE 104
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-5209
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Country | US
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Telephone | 248-888-8183
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEPHANIE MARIE ROSE
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Credential | D.C
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Telephone | 248-888-8183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2301008119
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License Number State | MI
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