Individual
MS. MARDY M ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1014945
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
840999425010
HMO
CO
01
—
P00349837
MEDICARE RAILROAD
CO
Enumeration date
12/13/2007
Last updated
12/13/2007
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