Individual
MRS. LETICIA MARIE ROSS-GLASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3540 SUMMER AVE STE 320, MEMPHIS, TN 38122-3600
(901) 623-6220
Mailing address
3540 SUMMER AVE STE 320, MEMPHIS, TN 38122-3600
(901) 623-6220
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
882060119
—
TN
Enumeration date
05/06/2022
Last updated
05/06/2022
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