Organization
ROSANTHORN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ROSE LAC, MSOM, LPN (PRESIDENT)
(262) 331-4083
Entity
Organization
Contact information
Practice address
4103 60TH ST, KENOSHA, WI 53144-2509
(262) 331-4083
Mailing address
4103 60TH ST, KENOSHA, WI 53144-2509
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
423055
WI
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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