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General NPI Number Information
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NPI Number | 1306058896
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Entity Type | Organization
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Legal Business Name | MODESTO CHIROPRACTIC CENTER, A ROSEN FAMILY CORP.
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 409 COFFEE ROAD
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-527-5346
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Fax | 209-527-0124
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Provider Business Mailing Address
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Address Line | 409 COFFEE ROAD
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City | MODESTO
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State | CA
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Zip | 95355
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Country | US
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Telephone | 209-527-5346
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Fax | 209-527-0124
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICHOLAS ROSEN
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Credential | D.C.
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Telephone | 209-527-5346
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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 | DC0147440
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License Number State | CA
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