Provider Demographics
NPI:1902008451
Name:ROSSITER, EARLE WILLIAM JR (DC)
Entity Type:Individual
Prefix:DR
First Name:EARLE
Middle Name:WILLIAM
Last Name:ROSSITER
Suffix:JR
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 1:5600 US HIGHWAY 98 N
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-3100
Mailing Address - Country:US
Mailing Address - Phone:863-859-5200
Mailing Address - Fax:863-859-5200
Practice Address - Street 1:5600 US HIGHWAY 98 N
Practice Address - Street 2:SUITE 6
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-3100
Practice Address - Country:US
Practice Address - Phone:863-859-5200
Practice Address - Fax:863-859-5200
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 5912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5912OtherLISENCE
FL5912OtherLISENCE