Individual
BRUCE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
314 DON FERNANDO ST, TAOS, NM 87571-5953
(505) 751-7037
Mailing address
282 S CAMINO DEL PUEBLO, STE 2-C, BERNALILLO, NM 87004-5909
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/12/2015
Last updated
06/12/2015
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