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Individual

MR. KENNETH ROSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7825 BUCKSTONE CT, PARMA, OH 44134
(440) 888-1334
Mailing address
7825 BUCKSTONE CT, PARMA, OH 44134
(440) 888-1334

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1815834
PROVIDER CONTRACT #
OH
05
3144645
OH
Enumeration date
11/20/2020
Last updated
11/20/2020
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