Individual
KACI ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 MARLSTONE PL, COLORADO SPRINGS, CO 80904-2989
(785) 632-0779
Mailing address
1110 MARLSTONE PL, COLORADO SPRINGS, CO 80904-2989
(785) 632-0779
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0022827
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17-133-8053
DRIVERS LICENSE
CO
Enumeration date
10/30/2019
Last updated
10/30/2019
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