Individual
KRYSTAL ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7905 E US HIGHWAY 66, EL RENO, OK 73036-9225
(405) 264-5567
(405) 264-5600
Mailing address
7905 E US HIGHWAY 66, EL RENO, OK 73036-9225
(405) 264-5567
(405) 264-5600
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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