| Jonathan Daniel Rosa, DC | |
|
955 Main St Apt 812, Bridgeport, CT 06604-4336 | |
| (787) 559-4057 | |
| Not Available |
| Full Name | Jonathan Daniel Rosa |
|---|---|
| Gender | Male |
| Speciality | Chiropractor |
| Location | 955 Main St Apt 812, Bridgeport, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609208164 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 1949 (Connecticut) | Primary |
| Provider Name | Optimus Health Care Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1669445946 PECOS PAC ID: 9335051580 Enrollment ID: O20031105000254 |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Daniel Rosa, DC 955 Main St Apt 812, Bridgeport, CT 06604-4336 Ph: (787) 559-4057 | Jonathan Daniel Rosa, DC 955 Main St Apt 812, Bridgeport, CT 06604-4336 Ph: (787) 559-4057 |
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