Individual
PAUL GARY ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
N6158 LAMBIE RD, DE PERE, WI 54115-6705
(920) 632-7031
(888) 959-6350
Mailing address
PO BOX 200, ONEIDA, WI 54155-0200
(920) 632-7031
(888) 959-6350
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/25/2019
Last updated
07/25/2019
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