Provider Demographics
NPI:1255404109
Name:DENNAN, ROSEANNE MARIE (DC)
Entity type:Individual
Prefix:
First Name:ROSEANNE
Middle Name:MARIE
Last Name:DENNAN
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:PO BOX 1228
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05255
Mailing Address - Country:US
Mailing Address - Phone:802-362-3040
Mailing Address - Fax:802-362-2811
Practice Address - Street 1:19 GREEN MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:MANCHESTER CENTER
Practice Address - State:VT
Practice Address - Zip Code:05255
Practice Address - Country:US
Practice Address - Phone:802-362-3040
Practice Address - Fax:802-362-2811
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT060000949111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor