Individual
MRS. BRENDA ANNE ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
29100 GATEWAY BLVD, SUITE 400, FLAT ROCK, MI 48134-2764
(734) 379-7900
Mailing address
29100 GATEWAY BLVD, SUITE 400, FLAT ROCK, MI 48134-2764
(734) 379-7900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501013896
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236836
MEDICARE PROVIDER
MI
Enumeration date
08/14/2008
Last updated
08/14/2008
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