Provider Demographics
NPI:1598830309
Name:MAROSSY, CAROLYN (DC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:MAROSSY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15347 MIDDLETOWN PARK DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-9736
Mailing Address - Country:US
Mailing Address - Phone:530-246-0317
Mailing Address - Fax:530-243-5089
Practice Address - Street 1:15347 MIDDLETOWN PARK DR
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-9736
Practice Address - Country:US
Practice Address - Phone:530-246-0317
Practice Address - Fax:530-243-5089
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC016611111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC016610Medicare ID - Type Unspecified