Individual
PENNY SUE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1086 SWAN DR, CRYSTAL, MI 48818-9777
(517) 647-3668
Mailing address
1086 SWAN DR, CRYSTAL, MI 48818-9777
(517) 647-3668
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/17/2023
Last updated
11/17/2023
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