Individual
BRIAN J. ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T., ATC
Contact information
Practice address
4660 RIVERSIDE PARK BLVD, MACON, GA 31210-1395
(478) 474-2114
(478) 474-5043
Mailing address
4660 RIVERSIDE PARK BLVD, MACON, GA 31210-1395
(478) 474-2114
(478) 474-5043
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007019
GA
2255A2300X
Athletic Trainer
AT000866
GA
Other
Enumeration date
04/19/2007
Last updated
06/23/2010
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