Provider Demographics
NPI:1538120951
Name:ROSNERMANZ, RON (DC PLLC)
Entity Type:Individual
Prefix:DR
First Name:RON
Middle Name:
Last Name:ROSNERMANZ
Suffix:
Gender:M
Credentials:DC PLLC
Other - Prefix:DR
Other - First Name:RONALD
Other - Middle Name:S
Other - Last Name:ROSNERMANZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1200 FERGUSON DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3503
Mailing Address - Country:US
Mailing Address - Phone:501-315-3310
Mailing Address - Fax:501-315-9262
Practice Address - Street 1:1200 FERGUSON DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3503
Practice Address - Country:US
Practice Address - Phone:501-315-3310
Practice Address - Fax:501-315-9262
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-28
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1538120951OtherRAILROAD MEDICARE - MEMBER NPI
AR1396805818OtherRAILROAD MEDICARE - GROUP NPI
AR19906000040OtherQUALCHOICE/QCA
AR4420065OtherUNITED HEALTHCARE
AR5T636OtherBLUE CROSS BLUE SHIELD
ARDP1248OtherRAILROAD MEDICARE - GROUP PTAN
ARDP1248OtherRAILROAD MEDICARE - GROUP PTAN
AR19906000040OtherQUALCHOICE/QCA