Individual
DR. MARK ROBIN ROUSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
3779 DAYTON XENIA RD, BEAVERCREEK, OH 45432-2829
(937) 426-3608
Mailing address
3779 DAYTON XENIA RD, BEAVERCREEK, OH 45432-2829
(937) 426-3608
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1004
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000012407
ANTHEM
OH
01
—
311132895-00
OHIO WORKERS COMP
OH
Enumeration date
03/06/2007
Last updated
07/08/2007
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