Individual
SANDRA ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1368 FOX TROT RD, SMITHTON, MO 65350-2112
(660) 596-2213
Mailing address
1368 FOX TROT RD, SMITHTON, MO 65350-2112
(660) 596-2213
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2011001377
MO
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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