MEDICARE: JENNIFER ROSS PTA

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	225200000X	Physical Therapy Assistant	008536	OH

General Provider Information

NPI Number	:	1396552972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ROSS PTA

Provider Business Mailing Address
First Line	:	3210 W FORK RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1948
Country	:	US
Telephone Number	:	513-605-3025
Fax Number	:

Provider Business Practice Location Address
First Line	:	3210 W FORK RD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1948
Country	:	US
Telephone Number	:	513-605-3025
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	12/16/2024

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Directions to “ JENNIFER ROSS PTA” Practice Location

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