Individual
MISTY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
667 HOPEWELL DRIVE, HEATH, OH 43056-1579
(740) 344-6557
Mailing address
667 HOPEWELL DRIVE, HEATH, OH 43056-1579
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 080109-LP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2155984
—
OH
Enumeration date
09/21/2007
Last updated
09/21/2007
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