Individual
MARTIN L. ROUSSEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
970 HOPE ST, BRISTOL, RI 02809-5210
(401) 253-7475
(401) 253-8927
Mailing address
970 HOPE ST, BRISTOL, RI 02809-5210
(401) 253-7475
(401) 253-8927
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DCP00188
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007002777
MEDICARE
RI
01
—
204125
BLUE CHIP
RI
01
—
44-00032
UNITED HEALTH CARE
RI
01
—
758968
TUFTS
RI
01
—
9043-0
BC/BS
RI
Enumeration date
12/06/2005
Last updated
01/07/2008
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