Provider Demographics
NPI:1942338058
Name:ROSEMAN CLINIC FOR CHINESE MEDICINE INC.
Entity Type:Organization
Organization Name:ROSEMAN CLINIC FOR CHINESE MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:ROSEMAN
Authorized Official - Suffix:III
Authorized Official - Credentials:LAC,DIPL CH, RH(AHG
Authorized Official - Phone:541-382-0720
Mailing Address - Street 1:402 NW ROANOKE AVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-1859
Mailing Address - Country:US
Mailing Address - Phone:541-382-0720
Mailing Address - Fax:541-382-0210
Practice Address - Street 1:402 NW ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-1859
Practice Address - Country:US
Practice Address - Phone:541-382-0720
Practice Address - Fax:541-382-0210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00629171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty