Individual
MRS. SANDRA JENNIE ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
INDEPENDENT PROVIDER
Contact information
Practice address
4183 STATE ROUTE 73, HILLSBORO, OH 45133-7803
(937) 393-8487
Mailing address
4183 STATE ROUTE 73, HILLSBORO, OH 45133-7803
(937) 393-8487
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2662542
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2662542
PROVIDER
OH
Enumeration date
03/15/2007
Last updated
07/08/2007
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