Individual
MRS. LUCEIN SUREIN MELLOY ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.
Contact information
Practice address
116 S CENTRAL AVE, MULVANE, KS 67110-1718
(316) 777-0977
Mailing address
122 JEANNETTE DR, MULVANE, KS 67110-1029
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-03247
KS
Other
Enumeration date
08/08/2007
Last updated
08/08/2007
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