Organization
DR RICHARD A ROSENBERG, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A ROSENBERG (OWNER)
(423) 282-1742
Entity
Organization
Contact information
Practice address
302 SUNSET DRIVE, STE 109, JOHNSON CITY, TN 37604-9999
(423) 282-1742
Mailing address
302 SUNSET DRIVE, STE 109, JOHNSON CITY, TN 37604-9999
(423) 282-1742
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TN0664
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3943775
—
TN
Enumeration date
08/21/2007
Last updated
09/05/2007
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