Individual
JACQUELINE ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
89 BONIFACE DR, PINE BUSH, NY 12566-7011
(845) 744-8079
Mailing address
82 SAWYER LN, PINE BUSH, NY 12566-5216
(845) 744-8079
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
003350
NY
Other
Enumeration date
03/21/2016
Last updated
03/21/2016
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