Individual
JACQUELINE ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 HICKORY RD, PLYMOUTH MEETING, PA 19462-1047
(800) 879-4471
Mailing address
1401 ROOT RD, LORAIN, OH 44052-2853
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
OT.003089
OH
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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