Individual
MARY HOWLAND DEROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
2935 SOUTHWEST DR, SEDONA, AZ 86336-3797
(928) 203-4863
(928) 203-4497
Mailing address
2935 SOUTHWEST DR, SEDONA, AZ 86336-3797
(928) 203-4863
(928) 203-4497
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7153
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0934200
BCBS
AZ
Enumeration date
02/20/2007
Last updated
07/16/2010
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