Individual
ROSEANNE DISHMAN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
135 W JACKSON ST, COOKEVILLE, TN 38501-3927
(931) 528-8362
(931) 528-8657
Mailing address
135 W JACKSON ST, COOKEVILLE, TN 38501-3927
(931) 528-8362
(931) 528-8657
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
104000516
VA
111N00000X
Chiropractor
Primary
DC430
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3673597
—
TN
01
—
57197
BCBS
TN
Enumeration date
10/27/2006
Last updated
07/09/2015
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