MEDICARE: DR JUSTIN ROSS PLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7827	AZ

General Provider Information

NPI Number	:	1144415019
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR JUSTIN ROSS PLC

Provider Business Mailing Address
First Line	:	3120 W CAREFREE HWY
Second Line	:	SUITE 1-342
City	:	PHOENIX
State	:	AZ
Zip	:	85086-3201
Country	:	US
Telephone Number	:	623-223-1350
Fax Number	:

Provider Business Practice Location Address
First Line	:	34406 N 27TH DR
Second Line	:	SUITE 116
City	:	PHOENIX
State	:	AZ
Zip	:	85085-6082
Country	:	US
Telephone Number	:	623-223-1350
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JUSTIN COLLIN ROSS
Credential	:	D.C.
Telephone Number	:	602-867-7463

Provider Enumeration Date	:	09/13/2007
Last Update Date	:	05/30/2013

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