Individual
GREGORY RAY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
COMDT(CG-1122), US COAST GUARD, 2100 2ND STREET SW, SUITE 5314, WASHINGTON, DC 20593-0001
(707) 839-6176
Mailing address
COMDT(CG-1122), US COAST GUARD, 2100 2ND STREET SW, SUITE 5314, WASHINGTON, DC 20593-0001
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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