Individual
JONATHAN ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
217 S 3RD ST, DANVILLE, KY 40422-1823
(859) 699-2991
Mailing address
137 BROOKVIEW DR, RICHMOND, KY 40475-3537
(859) 358-6492
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
TC262
KY
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/09/2022
Last updated
09/14/2022
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