# ROSE WELLNESS CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598159576
- **Authorized official:** CHAD ROSE D.C. (OWNER)
- **Authorized official phone:** (352) 775-2180

## Contact information

- **Practice address:** 910 OLD CAMP RD, SUITE 92, THE VILLAGES, FL 32162-5604
- **Practice address phone:** (352) 775-2180
- **Practice address fax:** (352) 775-2930
- **Mailing address:** 910 OLD CAMP RD, SUITE 92, THE VILLAGES, FL 32162-5604
- **Mailing address phone:** (386) 334-0133

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CH11031 | FL | — |
| 208D00000X | General Practice Physician | 053562 | FL | Yes |
| 225100000X | Physical Therapist | — | FL | — |

## Other

- **Enumeration date:** 03/26/2015
- **Last updated:** 08/30/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 009SS | BCBS | FL |