Individual
JUAN ROSALES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
823 17TH ST NW, EAST GRAND FORKS, MN 56721-1125
(701) 741-0239
Mailing address
823 17TH ST NW, EAST GRAND FORKS, MN 56721-1125
(701) 741-0239
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
119536
TX
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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