Individual
MR. LANNY ROSE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
536 BROKER HILL ROAD, BECKET, MA 01223
(413) 770-2928
Mailing address
PO BOX 412, BECKET, MA 01223-0412
(413) 770-2928
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9098
MA
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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