Individual
LORI KIRSTEN ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6520 JAYCOX RD, GALENA, OH 43021-9530
(614) 323-2186
Mailing address
67 W OAKLAND AVE, COLUMBUS, OH 43201-1222
(614) 323-2186
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
2519500
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2519500
—
OH
Enumeration date
05/01/2007
Last updated
07/08/2007
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