Provider Demographics
NPI:1699329110
Name:ROSSI, NATHANIEL J (DC)
Entity type:Individual
Prefix:
First Name:NATHANIEL
Middle Name:J
Last Name:ROSSI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:757 LONG POINT RD STE C
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8328
Mailing Address - Country:US
Mailing Address - Phone:843-897-6745
Mailing Address - Fax:
Practice Address - Street 1:757 LONG POINT RD STE C
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8328
Practice Address - Country:US
Practice Address - Phone:843-897-6745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4957111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor