Provider Demographics
NPI:1881902286
Name:ROSEWARNE, JAIME L (DC)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:L
Last Name:ROSEWARNE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1537 N LEROY ST
Mailing Address - Street 2:SUITE F
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2795
Mailing Address - Country:US
Mailing Address - Phone:810-629-6500
Mailing Address - Fax:810-629-6166
Practice Address - Street 1:1537 N LEROY ST
Practice Address - Street 2:SUITE F
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2795
Practice Address - Country:US
Practice Address - Phone:810-629-6500
Practice Address - Fax:810-629-6166
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009637111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor