Individual
THERESA ANN ROSS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
11050 MOUNT BELVEDERE BLVD, USA MEDDAC ATTN CREDENTIALS, FORT DRUM, NY 13602-5438
(315) 772-4025
(315) 772-9498
Mailing address
12301 COLBY LAKE RD, PO BOX 568, LAINGSBURG, MI 48848-9313
(517) 290-3875
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
4704123246
MI
Other
Enumeration date
02/14/2006
Last updated
07/08/2007
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