Individual
MR. LARRY JAMES ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
2600 STATE LINE RD, ELIZABETHTON, TN 37643-7204
(423) 542-4245
(423) 542-4369
Mailing address
2600 STATE LINE RD, ELIZABETHTON, TN 37643-7204
(423) 542-4245
(423) 542-4369
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904003461
VA
1041C0700X
Clinical Social Worker
Primary
LSW0000000484
TN
Other
Enumeration date
09/12/2007
Last updated
09/12/2007
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