Provider Demographics
NPI:1780728006
Name:ROSSELAND, ERIK JASON (DC)
Entity type:Individual
Prefix:DR
First Name:ERIK
Middle Name:JASON
Last Name:ROSSELAND
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1658
Mailing Address - Country:US
Mailing Address - Phone:520-444-1937
Mailing Address - Fax:
Practice Address - Street 1:3670 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1658
Practice Address - Country:US
Practice Address - Phone:520-444-1937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5632111N00000X
TX6909111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor