Provider Demographics
NPI:1881618379
Name:STAUFFER-ROSSI, MARIE ANN (DC)
Entity type:Individual
Prefix:DR
First Name:MARIE
Middle Name:ANN
Last Name:STAUFFER-ROSSI
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 1:275 GRAHAM RD
Mailing Address - Street 2:SUITE 9
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2259
Mailing Address - Country:US
Mailing Address - Phone:330-945-5555
Mailing Address - Fax:330-945-6318
Practice Address - Street 1:275 GRAHAM RD
Practice Address - Street 2:SUITE 9
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2259
Practice Address - Country:US
Practice Address - Phone:330-945-5555
Practice Address - Fax:330-945-6318
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1812111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0878822Medicaid
OHST0717221Medicare ID - Type Unspecified
OH0878822Medicaid