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Organization

ROSSCO LLC

Active
Other names
Live Well MD
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STEPHEN HAROLD ROSS (PRACTICE ADMINSTRATOR)
(912) 352-1234
Entity
Organization

Contact information

Practice address
3 JOHNSTON ST, SUITE B, SAVANNAH, GA 31405-5502
(912) 352-1234
Mailing address
3 JOHNSTON ST, SUITE B, SAVANNAH, GA 31405-5502
(912) 352-1234

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
055437
GA

Other

Enumeration date
03/04/2013
Last updated
03/04/2013
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