Organization
ROSE WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM SHARON ROSE M.D. (MANAGING MEMBER)
(405) 567-1169
Entity
Organization
Contact information
Practice address
3204 NBU, 1022 W MAIN ST, PRAGUE, OK 74864-4516
(405) 567-1169
Mailing address
3204 NBU, 1022 W MAIN ST, PRAGUE, OK 74864-4516
(405) 567-1169
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2009
Last updated
12/16/2009
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