Individual
JESSE SHELTON ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 E GORDON AVE, HARRISON, AR 72601-5923
(870) 391-9056
Mailing address
520 E GORDON AVE, HARRISON, AR 72601-5923
(870) 391-9056
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
171M00000X
—
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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