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General NPI Number Information
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NPI Number | 1508008814
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Entity Type | Organization
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Legal Business Name | NMRS, P.C.
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 267 CREEKSIDE DR SUITE 200
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City | PETOSKEY
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State | MI
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Zip | 49770-7609
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Country | US
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Telephone | 231-348-1995
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Fax | 231-347-3223
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Provider Business Mailing Address
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Address Line | 267 CREEKSIDE DR SUITE 200
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City | PETOSKEY
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State | MI
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Zip | 49770-7609
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Country | US
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Telephone | 231-348-1995
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Fax | 231-347-3223
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KEITH DALE ROSE
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Credential | M.D.
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Telephone | 231-348-1995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 4301064558
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License Number State | MI
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