Individual
BETH A ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
533 W COLUMBIA ST, EVANSVILLE, IN 47710-1617
(812) 759-3001
(812) 401-9013
Mailing address
7300 E INDIANA ST, EVANSVILLE, IN 47715-2794
(812) 476-0409
(812) 476-1016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009014A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000484965
BLUE CROSS BLUE SHIELD
IN
05
—
200829330
—
IN
Enumeration date
07/31/2006
Last updated
02/05/2010
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