Individual
GARRY LEONARD ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
YPSS CERTIFIED
Contact information
Practice address
1072 S DIXIE BLVD, RADCLIFF, KY 40160-1103
(270) 473-1624
Mailing address
1072 S DIXIE BLVD, RADCLIFF, KY 40160-1103
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
KY
Other
Enumeration date
07/31/2019
Last updated
05/13/2020
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