Individual
JONATHAN ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS CCC-A
Contact information
Practice address
1950 BLUEGRASS CIR STE 150, CHEYENNE, WY 82009-7362
(307) 632-8224
(307) 514-0315
Mailing address
1950 BLUEGRASS CIR STE 150, CHEYENNE, WY 82009-7362
(307) 632-8224
(307) 514-0315
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A-951
WY
231H00000X
Audiologist
—
—
237600000X
Audiologist-Hearing Aid Fitter
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
332S00000X
—
WY
01
—
P00221755
RR MEDICARE NUMBER
WY
Enumeration date
10/23/2006
Last updated
09/20/2021
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