Individual
MR. BRIAN L ROSCOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
727 WASHINGTON ST, GRAND HAVEN, MI 49417-1458
(616) 847-1444
(616) 847-1711
Mailing address
727 WASHINGTON ST, GRAND HAVEN, MI 49417-1458
(616) 847-1444
(616) 847-1711
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2301005392
MI
111N00000X
Chiropractor
MC03333
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G01069
BLUE CROSS
MI
05
—
141B11174
—
MI
01
—
BR 005392
PPOM
MI
Enumeration date
03/28/2007
Last updated
07/08/2007
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