Provider Demographics
NPI:1255327961
Name:SCOTTT, ROSEMARIE ANN (DC)
Entity type:Individual
Prefix:DR
First Name:ROSEMARIE
Middle Name:ANN
Last Name:SCOTTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5880 N 175 W
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:IN
Mailing Address - Zip Code:46746-9404
Mailing Address - Country:US
Mailing Address - Phone:260-768-4324
Mailing Address - Fax:
Practice Address - Street 1:935 N VAN BUREN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SHIPSHEWANA
Practice Address - State:IN
Practice Address - Zip Code:46565-8702
Practice Address - Country:US
Practice Address - Phone:260-768-4061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000843A111N00000X
MIL557711111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000182246OtherBLUE CROSS
IN000000182246OtherBLUE CROSS
INT34844Medicare UPIN