Individual
DR. TIMOTHY D. ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2941 ZELDA RD STE B, MONTGOMERY, AL 36106-2699
(334) 264-7948
(334) 264-8616
Mailing address
PO BOX 230427, MONTGOMERY, AL 36123-0427
(334) 264-7948
(334) 264-8616
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2094
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
510-01480
BCBS
AL
01
—
K375
MEDICARE GROUP NUMBER
AL
01
—
P00271767
MC RAILROAD
AL
Enumeration date
01/08/2007
Last updated
03/12/2008
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