Provider Demographics
NPI:1760468417
Name:SCHMIDT, ROSEANN (DC)
Entity Type:Individual
Prefix:DR
First Name:ROSEANN
Middle Name:
Last Name:SCHMIDT
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 1:138 LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1111
Mailing Address - Country:US
Mailing Address - Phone:215-968-9078
Mailing Address - Fax:
Practice Address - Street 1:4019 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:PA
Practice Address - Zip Code:18969-1126
Practice Address - Country:US
Practice Address - Phone:215-480-0214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003529L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU12110Medicare UPIN
PA549271Medicare ID - Type Unspecified