Provider Demographics
NPI:1093808073
Name:ROSBOROUGH, CHAD EDWIN (DC)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:EDWIN
Last Name:ROSBOROUGH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20300 ROUTE 19 UNIT 11
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6126
Mailing Address - Country:US
Mailing Address - Phone:724-776-0001
Mailing Address - Fax:724-776-9355
Practice Address - Street 1:20300 ROUTE 19 UNIT 11
Practice Address - Street 2:
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-6126
Practice Address - Country:US
Practice Address - Phone:724-776-0001
Practice Address - Fax:724-776-9355
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC008778111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA056262Medicare ID - Type Unspecified