Provider Demographics
NPI:1356421127
Name:ROUSLIN, MAX O (DC)
Entity type:Individual
Prefix:DR
First Name:MAX
Middle Name:O
Last Name:ROUSLIN
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:PO BOX 15424
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28813-0424
Mailing Address - Country:US
Mailing Address - Phone:828-277-9990
Mailing Address - Fax:828-277-8088
Practice Address - Street 1:780 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 17
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-2900
Practice Address - Country:US
Practice Address - Phone:828-277-9990
Practice Address - Fax:828-277-8088
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890829WMedicaid
NC2452065Medicare ID - Type Unspecified
NCU68988Medicare UPIN