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1063228849
LANCE DIAMOND ROSE
LOUISA, KY
NPI
1063228849
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2024-12-06
Last Update Date
2024-12-06
Business Address
LANCE DIAMOND ROSE PSS
125 S MAIN CROSS ST
LOUISA, KY 41230-1330
Phone number: 606-638-0938
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Mailing Address
LANCE DIAMOND ROSE PSS
PO BOX 726
LOUISA, KY 41230-0726
Phone number: 606-638-0938
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