Individual
MRS. KATHARINE BANNING ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
EDM, AT, ATC
Contact information
Practice address
222 FAIRBANKS AVE, HOLLAND, MI 49423-3735
(815) 757-7287
Mailing address
222 FAIRBANKS AVE, HOLLAND, MI 49423-3735
(815) 757-7287
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001256
MI
Other
Enumeration date
01/26/2015
Last updated
01/26/2015
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