Individual
JENNIFER ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
360 COLLEGE ST, BLAKELY, GA 39823-2554
(229) 723-2660
Mailing address
360 COLLEGE ST, BLAKELY, GA 39823-2554
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
006328
GA
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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