Individual
COURTNEY E ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
203 NACOGDOCHES ST, SUITE 275, JACKSONVILLE, TX 75766-2462
(309) 541-5472
(903) 541-5470
Mailing address
203 NACOGDOCHES ST, SUITE 275, JACKSONVILLE, TX 75766-2462
(309) 541-5472
(903) 541-5470
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
N9947
TX
Other
Enumeration date
06/15/2011
Last updated
07/30/2012
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