Individual
DOMINIK NICOLE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
215 PERRY HILL RD, MONTGOMERY, AL 36109-3725
(334) 328-9483
Mailing address
6912 EPPERSON DR, MONTGOMERY, AL 36117-4420
(334) 328-9483
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-174174
AL
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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