Provider Demographics
NPI:1851586457
Name:ROMAN, MARY-LYNNE (DC)
Entity Type:Individual
Prefix:DR
First Name:MARY-LYNNE
Middle Name:
Last Name:ROMAN
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 1:6 BARBERRY ACRES
Mailing Address - Street 2:
Mailing Address - City:CANDLER
Mailing Address - State:NC
Mailing Address - Zip Code:28715-8156
Mailing Address - Country:US
Mailing Address - Phone:828-667-8212
Mailing Address - Fax:
Practice Address - Street 1:6 BARBERRY ACRES
Practice Address - Street 2:
Practice Address - City:CANDLER
Practice Address - State:NC
Practice Address - Zip Code:28715-8156
Practice Address - Country:US
Practice Address - Phone:828-667-8212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2055111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2448435Medicare PIN