Individual
HARRIS A ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
328 W GODFREY AVENUE, PHILADELPHIA, PA 19120
(215) 276-1122
(215) 549-4007
Mailing address
328 W GODFREY AVENUE, PHILADELPHIA, PA 19120
(215) 276-1122
(215) 549-4007
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
OS002098L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0547727000
KEYSTONE
—
01
—
118986800
DOL
—
Enumeration date
03/07/2007
Last updated
03/19/2009
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