Individual
MICHAEL EVAN ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C PED
Contact information
Practice address
1023 EMMET ST N, CHARLOTTESVILLE, VA 22903-4834
(434) 245-0205
Mailing address
1621 QUAIL RUN, CHARLOTTESVILLE, VA 22911-9054
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
—
—
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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