Provider Demographics
NPI:1396805818
Name:RON ROSNERMANZ DC PLLC
Entity type:Organization
Organization Name:RON ROSNERMANZ DC PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RON
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSNERMANZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-315-3310
Mailing Address - Street 1:1200 FERGUSON DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3503
Mailing Address - Country:US
Mailing Address - Phone:501-315-3310
Mailing Address - Fax:501-315-9262
Practice Address - Street 1:1200 FERGUSON DR
Practice Address - Street 2:SUITE 2
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3503
Practice Address - Country:US
Practice Address - Phone:501-315-3310
Practice Address - Fax:501-315-9262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1460111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1538120951OtherINDIVIDUAL NPI #
AR5T636OtherINDIV. BCBS & MC FOR ROSN
AR5C325OtherBCBS GROUP #
AR990007654OtherRAILROAD MEDICARE
AR4420065OtherUNITEDHEALTHCARE
AR19906000040OtherQUALCHOICE QCA
AR5C325Medicare ID - Type UnspecifiedGROUP MEDICARE #
AR19906000040OtherQUALCHOICE QCA