Individual
HAILEY J ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6615 COMANCHE ST, KANIKSU HEALTH SERVICES, BONNERS FERRY, ID 83805
(208) 267-1718
(208) 267-9197
Mailing address
PO BOX Q, KANIKSU HEALTH SERVICES, BONNERS FERRY, ID 83805-1200
(208) 267-1718
(208) 267-9197
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
LL1272
SC
Other
Enumeration date
07/07/2009
Last updated
09/14/2012
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