Individual
MISTY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
119 GOLDSMITH AVE, EAST PROVIDENCE, RI 02914-2203
(401) 301-7533
Mailing address
119 GOLDSMITH AVE, EAST PROVIDENCE, RI 02914-2203
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9164
MA
Other
Enumeration date
06/28/2016
Last updated
06/28/2016
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