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1205050473
LISA ANN ROSE
PEORIA, IL
NPI
1205050473
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: IL 164-001727)
Enumeration Date
2007-04-12
Last Update Date
2007-07-08
Business Address
Ms. LISA ANN ROSE RD, LDN
221 NE GLEN OAK AVE
PEORIA, IL 61636-0002
Phone number: 309-672-4954
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Mailing Address
Ms. LISA ANN ROSE RD, LDN
708 N ASHLAND AVE
WEST PEORIA, IL 61604-4903
Phone number: 309-637-6593
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