Individual
JASON ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1713 GIBSON ST, WEST PLAINS, MO 65775-1815
(417) 256-8393
(417) 256-8393
Mailing address
1713 GIBSON ST, WEST PLAINS, MO 65775-1815
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2001024885
MO
Other
Enumeration date
06/24/2008
Last updated
07/03/2008
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