The Rose Clinic for Plastic and Migraine Surgery

NPI #1093990210 in Provo, Utah

Provider Information

NPI Number: 1093990210
Entity Type: Organization
Organization Name: The Rose Clinic for Plastic and Migraine Surgery
Primary Specialty: Specialist
Enumeration Date: Jan 7, 2008
Last Updated: Jun 13, 2008

Practice Location

Address: 320 RIVER PARK DR
Address 2: SUITE 245
City: Provo
State: Utah
ZIP Code: 84604-6060
Phone: (801) 375-7673

Authorized Official

Name: DR. KEVIN G ROSE, M.D.
Title: DOCTOR/OWNER
Phone: (801) 375-7673

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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