Individual
MS. KATHLEEN M ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 MARTIN LUTHER KING JR. BLVD., WORCESTER, MA 01608-1209
(508) 754-3823
(508) 753-0151
Mailing address
100 MARTIN LUTHER KING JR. BLVD., WORCESTER, MA 01608-1209
(508) 754-3823
(508) 753-0151
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
106
MA
Other
Enumeration date
11/03/2005
Last updated
07/11/2011
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