Provider Demographics
NPI:1598718587
Name:HALL, ROSEMARY KAY (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:KAY
Last Name:HALL
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:ROSEMARY
Other - Middle Name:KAY
Other - Last Name:DIAMOND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:PO BOX 324
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37879
Mailing Address - Country:US
Mailing Address - Phone:423-626-8223
Mailing Address - Fax:800-507-1093
Practice Address - Street 1:1450 BROAD ST
Practice Address - Street 2:SUITE 1
Practice Address - City:TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37879
Practice Address - Country:US
Practice Address - Phone:423-626-8223
Practice Address - Fax:800-507-1093
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2095111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
4121327OtherBCBS TN
1834233OtherCIGNA
4121327OtherBCBS TN
1834233OtherCIGNA