Individual
MR. COURTNEY BRANDON ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DHA, MSN, RN, CNL
Contact information
Practice address
175 GWINNETT DR, LAWRENCEVILLE, GA 30046-8444
(678) 209-2394
Mailing address
1464 WILFORD DR, LAWRENCEVILLE, GA 30043-8221
(229) 942-0615
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN279918
GA
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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