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1770787509
MICHAEL P ROSE
ROCKFORD, IL
NPI
1770787509
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096001973)
Enumeration Date
2007-06-14
Last Update Date
2008-05-20
Business Address
-- MICHAEL P ROSE LAT
735 HIGHGROVE PL
ROCKFORD, IL 61108-2520
Phone number: 815-226-4365
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Mailing Address
-- MICHAEL P ROSE LAT
3534 N WILTON AVE APT 1
CHICAGO, IL 60657-1709
Phone number:
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