Provider Demographics
NPI:1134514862
Name:ROSE, KELSEY ERIN (DC)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:ERIN
Last Name:ROSE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 LANDA ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-5407
Mailing Address - Country:US
Mailing Address - Phone:830-629-3101
Mailing Address - Fax:830-626-8245
Practice Address - Street 1:395 LANDA ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-5407
Practice Address - Country:US
Practice Address - Phone:830-629-3101
Practice Address - Fax:830-626-8245
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12904111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor