MICHAEL P ROSE

ROCKFORD, IL
NPI1770787509
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  096001973)
Enumeration Date2007-06-14
Last Update Date2008-05-20
Business Address
-- MICHAEL P ROSE LAT
735 HIGHGROVE PL
ROCKFORD, IL 61108-2520
Phone number: 815-226-4365
Mailing Address
-- MICHAEL P ROSE LAT
3534 N WILTON AVE APT 1
CHICAGO, IL 60657-1709
Phone number: