Individual
SAMANTHA ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
272 GARDNER LANE, JACKSBORO, TN 37757
(423) 201-1254
Mailing address
272 GARDNER LN, JACKSBORO, TN 37757-3908
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5429
TN
Other
Enumeration date
07/14/2014
Last updated
07/14/2014
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