Individual
MR. LAWRENCE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
2 LAUREL AVE, WELLESLEY, MA 02481-7523
(781) 237-5585
(781) 237-5633
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
MA
2251X0800X
Orthopedic Physical Therapist
Primary
002762
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18901
CIGNA/ORTHONET ID NUMBER
CT
01
—
2019893
AETNA ID NUMBER
CT
01
—
50RPTINC0CT01
BLUE CROSS BLUE SHIELD NU
CT
01
—
764202
CONNECTICARE ID NUMBER
CT
01
—
ANC1685
OXFORD ID NUMBER
CT
Enumeration date
07/25/2006
Last updated
01/09/2024
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