Individual
MARY C ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(414) 219-2000
Mailing address
3801 N 92ND ST, MILWAUKEE, WI 53222-2503
(414) 535-1956
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1115
WI
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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