Provider Demographics
NPI:1356493027
Name:ROSA, JOHN PETER (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PETER
Last Name:ROSA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:30 W GUDE DR
Mailing Address - Street 2:SUITE 375
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1161
Mailing Address - Country:US
Mailing Address - Phone:301-545-0800
Mailing Address - Fax:301-545-0885
Practice Address - Street 1:30 W GUDE DR
Practice Address - Street 2:SUITE 375
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-1161
Practice Address - Country:US
Practice Address - Phone:301-545-0800
Practice Address - Fax:301-545-0885
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDS01623111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor