Individual
ROSE RICKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2816 ASPEN GROVE CT NW, ROANOKE, VA 24017-3160
(540) 330-2914
Mailing address
2816 ASPEN GROVE CT NW, ROANOKE, VA 24017-3160
(540) 330-2914
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
122772
VA
Other
Enumeration date
05/05/2015
Last updated
05/05/2015
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