Provider Demographics
NPI:1922841170
Name:ROSA ROSADO, JESSLIAN (DC)
Entity type:Individual
Prefix:DR
First Name:JESSLIAN
Middle Name:
Last Name:ROSA ROSADO
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 1:950 E MAIN ST APT 809
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-2286
Mailing Address - Country:US
Mailing Address - Phone:939-261-3500
Mailing Address - Fax:
Practice Address - Street 1:1269 BARCLAY CIR SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2903
Practice Address - Country:US
Practice Address - Phone:770-426-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR011030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor