Individual
MR. KEVIN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
304 TUSCOLA RD, BAY CITY, MI 48708-6896
(989) 892-8564
Mailing address
1545 KEYSTONE AVE, LANSING, MI 48911-4039
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6401014426
MI
Other
Enumeration date
11/11/2014
Last updated
11/11/2014
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