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Individual

SEAN ROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
11900 KANIS RD STE D4, LITTLE ROCK, AR 72211-3769
(501) 221-6009
Mailing address
11900 KANIS RD STE D4, LITTLE ROCK, AR 72211-3769
(501) 221-6009

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR790
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OTR790
LICENSE
AR
Enumeration date
01/22/2019
Last updated
01/22/2019
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