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General NPI Number Information
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NPI Number | 1821279654
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Entity Type | Individual
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Provider Name | HERBERT DIETMAR ROSENBERG DC
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Gender | Male
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 288 N IRONWOOD DR STE 108
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120-3830
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Country | US
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Telephone | 480-735-1034
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Fax | 480-983-1275
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Provider Business Mailing Address
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Address Line | 288 N IRONWOOD DR STE 108
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City | APACHE JUNCTION
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State | AZ
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Zip | 85120-3830
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Country | US
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Telephone | 480-735-1034
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Fax | 480-983-1275
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7864
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License Number State | AZ
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