Provider Demographics
NPI:1710129838
Name:ROSKAMP, JOEL CHRISTOPHER (DC)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:CHRISTOPHER
Last Name:ROSKAMP
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 1:628 W SEVENTH ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2435
Mailing Address - Country:US
Mailing Address - Phone:231-360-5853
Mailing Address - Fax:
Practice Address - Street 1:2506 CROSSING CIR
Practice Address - Street 2:SUITE A
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7955
Practice Address - Country:US
Practice Address - Phone:231-421-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-03
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009660111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic