Provider Demographics
NPI:1477880128
Name:ROSENCRANS CHIROPRACTIC, INC
Entity Type:Organization
Organization Name:ROSENCRANS CHIROPRACTIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROSENCRANS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:949-631-1440
Mailing Address - Street 1:2700 WEST COAST HWY
Mailing Address - Street 2:SUITE 234
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663
Mailing Address - Country:US
Mailing Address - Phone:949-631-1440
Mailing Address - Fax:949-631-1410
Practice Address - Street 1:2700 W COAST HWY
Practice Address - Street 2:SUITE 234
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4725
Practice Address - Country:US
Practice Address - Phone:949-631-1440
Practice Address - Fax:949-631-1410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC 256614111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty