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Individual

ROSE FORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
11606 SOUTHFORK AVE STE 101, BATON ROUGE, LA 70816-5235
(225) 293-2913
Mailing address
11606 SOUTHFORK AVE STE 101, BATON ROUGE, LA 70816-5235
(225) 293-2913

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PLC6493
LA

Other

Enumeration date
04/19/2016
Last updated
04/19/2016
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