Healthcare Provider Details

I. General information

NPI: 1881374296
Provider Name (Legal Business Name): ROSS AND SONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2023
Last Update Date: 10/03/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7058 STAGECOACH DR
PARK CITY UT
84098-5330
US

IV. Provider business mailing address

7058 STAGECOACH DR
PARK CITY UT
84098-5330
US

V. Phone/Fax

Practice location:
  • Phone: 801-613-1330
  • Fax:
Mailing address:
  • Phone: 801-613-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WREN ROSS
Title or Position: OWNER
Credential:
Phone: 801-613-1330