Provider Demographics
NPI:1275627382
Name:ROOST, CHARLES FRANCIS (DC)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FRANCIS
Last Name:ROOST
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 1:722 N CREYTS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48917-8608
Mailing Address - Country:US
Mailing Address - Phone:517-321-3030
Mailing Address - Fax:517-321-7015
Practice Address - Street 1:6130 W SAGINAW HWY
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48917-2465
Practice Address - Country:US
Practice Address - Phone:888-722-2370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICR004303111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI950B350250OtherBCBS
P00216640OtherRAILROAD MEDICARE
MI0B35025Medicare ID - Type Unspecified