Provider Demographics
NPI:1568058840
Name:COLON ROSADO, OSVALDO JOSE (DC)
Entity Type:Individual
Prefix:DR
First Name:OSVALDO
Middle Name:JOSE
Last Name:COLON ROSADO
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 1:8161 DOUBLE EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-7177
Mailing Address - Country:US
Mailing Address - Phone:787-382-8566
Mailing Address - Fax:
Practice Address - Street 1:5038 HUNTER RD
Practice Address - Street 2:
Practice Address - City:OOLTEAH
Practice Address - State:TN
Practice Address - Zip Code:37363
Practice Address - Country:US
Practice Address - Phone:423-910-9977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3360111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor