Individual
GENNY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2321 DUNN AVE, CHEYENNE, WY 82001-3214
(307) 314-9789
Mailing address
1312 E 23RD ST, CHEYENNE, WY 82001-4008
(307) 630-3667
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
124
WY
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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