Individual
SCOTT LORAY ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1110 N LEE AVE, OKLAHOMA CITY, OK 73103-2612
(405) 230-9000
(405) 230-9424
Mailing address
PO BOX 268981, OKLAHOMA CITY, OK 73126-8981
(405) 230-9000
(405) 230-9175
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA691
OK
Other
Enumeration date
07/15/2005
Last updated
07/11/2007
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