Individual
GINA ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 BRIGHTWATER DR, MYRTLE BEACH, SC 29579-8275
(843) 903-8300
Mailing address
2184 BREWSTER DR, UNIT 828, MYRTLE BEACH, SC 29577-1752
(843) 455-9952
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3097
SC
Other
Enumeration date
10/17/2014
Last updated
10/17/2014
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