Organization
ROSSELLO FAMILY CHIROPRACTIC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE GRACE ROSSELLO D.C. (PRESIDENT)
(301) 464-9400
Entity
Organization
Contact information
Practice address
4000 MITCHELLVILLE RD, SUITE B122, BOWIE, MD 20716-3104
(301) 464-9400
Mailing address
4000 MITCHELLVILLE RD, SUITE B122, BOWIE, MD 20716-3104
(301) 464-9400
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
S01133
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
452A
MD CAREFIRST PROV #
MD
01
—
876235
MAILHANDLERS PROV #
MD
01
—
J5880001
CAREFIRST BCBS DC PROV #
MD
Enumeration date
04/24/2007
Last updated
06/23/2010
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