Healthcare Provider Details

I. General information

NPI: 1285964940
Provider Name (Legal Business Name): ROSE MARY HOSEK L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 12/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 COURT ST
ROCKWELL CITY IA
50579-1416
US

IV. Provider business mailing address

411 COURT ST
ROCKWELL CITY IA
50579-1416
US

V. Phone/Fax

Practice location:
  • Phone: 712-297-5556
  • Fax: 712-297-5556
Mailing address:
  • Phone: 712-297-5556
  • Fax: 712-297-5556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberA58
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: