Provider Demographics
NPI:1396069027
Name:ROSEN, CHAIM (DC)
Entity type:Individual
Prefix:DR
First Name:CHAIM
Middle Name:
Last Name:ROSEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:
Other - Last Name:ROSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:5365 SEATON DR
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4536
Mailing Address - Country:US
Mailing Address - Phone:674-744-4874
Mailing Address - Fax:
Practice Address - Street 1:5365 SEATON DR
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-4536
Practice Address - Country:US
Practice Address - Phone:674-744-4874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-24
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR008582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor