Provider Demographics
NPI:1548297823
Name:KAMALEE ROSE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:KAMALEE ROSE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMALEE
Authorized Official - Middle Name:APRIL, AMOY
Authorized Official - Last Name:ROSE-ASH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-584-8800
Mailing Address - Street 1:536 GREENHILL AVE
Mailing Address - Street 2:THE COURT
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1851
Mailing Address - Country:US
Mailing Address - Phone:302-584-8800
Mailing Address - Fax:
Practice Address - Street 1:536 GREENHILL AVE
Practice Address - Street 2:THE COURT
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1851
Practice Address - Country:US
Practice Address - Phone:302-584-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000575111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG01738Medicare ID - Type Unspecified