Individual
MARILYN ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
53940 CARMICHAEL DR, SOUTH BEND, IN 46635-1564
(574) 335-6212
Mailing address
707 CEDAR ST STE 406, SOUTH BEND, IN 46617-2059
(574) 335-8707
(574) 335-0741
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05002653A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300043421
—
IN
Enumeration date
09/17/2020
Last updated
03/27/2024
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