Individual
MISS OLIVIA GRACE ROSALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 E PINE KNOLL DR, FLAGSTAFF, AZ 86011-0001
(928) 523-7147
(928) 523-6195
Mailing address
4636 E SANDRA TER, PHOENIX, AZ 85032-3438
(602) 319-8347
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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