Individual
DERALD ROSS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2717 NW 178TH ST APT 805, EDMOND, OK 73012-9322
(405) 339-2996
Mailing address
2717 NW 178TH ST APT 805, EDMOND, OK 73012-9322
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/07/2026
Last updated
07/07/2026
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