Individual
MR. RICHARD L ROSS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
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
Update your record
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