Individual
NELLIE SUE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
21 MALLARD CT, BECKLEY, WV 25801-3615
(304) 890-8020
Mailing address
PO BOX 203, PROSPERITY, WV 25909-0203
(304) 712-6289
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2020-3800
WV
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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