Individual
MR. RICHARD L ROSS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
68 NATIONAL DR, GLASTONBURY, CT 06033
(860) 633-8040
(860) 633-8047
Mailing address
PO BOX 444, GLASTONBURY, CT 06033
(860) 633-8040
(860) 633-8047
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004782
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080004782CT16
BC
CT
01
—
4339765CT
AETNA
CT
01
—
52301
ORTHONET
CT
Enumeration date
08/29/2007
Last updated
08/29/2007
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