Provider Demographics
NPI:1780733295
Name:MROSKI, DAVID V (DC)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:V
Last Name:MROSKI
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 1:1551 HIGHWAY 59
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-3729
Mailing Address - Country:US
Mailing Address - Phone:985-624-2971
Mailing Address - Fax:985-624-2972
Practice Address - Street 1:3041 E CAUSEWAY APPROACH
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-3510
Practice Address - Country:US
Practice Address - Phone:985-624-2971
Practice Address - Fax:985-624-2972
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1075111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5T895CP73Medicare ID - Type Unspecified
LAU60118Medicare UPIN