Ellis, Roseanne Dishman

Ellis, Roseanne Dishman is an sole proprietor health care provider with primary practice located at 135 W Jackson St , Cookeville TN 38501-3927. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Ellis, Roseanne Dishman can be contacted via phone (931) 528-8362.

Contact Information

Primary practice address
135 W Jackson St Cookeville TN 38501-3927
Phone: (931) 528-8362
Fax: (931) 528-8657
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X DC430 Tennessee
Chiropractic Providers / Chiropractor 111N00000X 104000516 Virginia

Profile Details

NPI number 1598841256
LBN Legal business name Ellis, Roseanne Dishman
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 27th, 2006
Last updated Jul 9th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598841256 NPPES
Tennessee Other 57197 BCBS
Tennessee MEDICAID 3673597 BCBS

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