Individual
MRS. MILDRED ELAINE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8043 PLAINFIELD RD, KIMBOLTON, OH 43749-9736
(740) 432-4140
Mailing address
8043 PLAINFIELD RD, KIMBOLTON, OH 43749-9736
(330) 605-7458
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/13/2020
Last updated
04/05/2024
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