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General NPI Number Information
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NPI Number | 1174344980
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Entity Type | Individual
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Provider Name | TROY ROSS
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Gender | Male
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 251 JORDAN RD SUITE 2
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City | SEDONA
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State | AZ
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Zip | 86336
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Country | US
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Telephone | 928-963-2038
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Fax |
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Provider Business Mailing Address
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Address Line | 125 INDIAN RUIN RD
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City | SEDONA
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State | AZ
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Zip | 86351-7346
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Country | US
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Telephone | 313-580-4339
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT-28930
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License Number State | AZ
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