Individual
ALLYSON LEIGH ROSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4600 MEMORIAL DR STE W3, BELLEVILLE, IL 62226-5359
(618) 222-8900
(618) 416-4449
Mailing address
4600 MEMORIAL DR STE W3, BELLEVILLE, IL 62226-5359
(618) 222-8900
(618) 416-4449
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.006541
IL
363AM0700X
Medical Physician Assistant
1150728
MA
Other
Enumeration date
02/07/2018
Last updated
04/07/2021
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