Healthcare Provider Details

I. General information

NPI: 1265071344
Provider Name (Legal Business Name): WALTER ROSS DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2020
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9097 E DESERT COVE AVE STE 110
SCOTTSDALE AZ
85260-6276
US

IV. Provider business mailing address

14287 N 87TH ST STE 220
SCOTTSDALE AZ
85260-3698
US

V. Phone/Fax

Practice location:
  • Phone: 480-860-4298
  • Fax: 480-860-0165
Mailing address:
  • Phone: 602-559-9707
  • Fax: 480-860-0356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberCP029354T
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: