Individual
JENNIFER ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6501 BROADWAY EXT STE 180, OKLAHOMA CITY, OK 73116-8246
(405) 607-4041
Mailing address
6501 BROADWAY EXT STE 180, OKLAHOMA CITY, OK 73116-8246
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/16/2018
Last updated
02/16/2018
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