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General NPI Number Information
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NPI Number | 1336510478
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Entity Type | Organization
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Legal Business Name | LAWRENCE A ROSS DC
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Dates
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Enumeration Date | 10/15/2015
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Last Update Date | 10/15/2015
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Provider Practice Location Address
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Address Line | 5420 ORANGE AVE
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City | FORT PIERCE
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State | FL
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Zip | 34947-1319
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Country | US
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Telephone | 772-409-4774
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Fax | 772-409-4774
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Provider Business Mailing Address
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Address Line | 5420 ORANGE AVE
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City | FORT PIERCE
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State | FL
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Zip | 34947-1319
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Country | US
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Telephone | 772-409-4774
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Fax | 772-409-4774
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Authorized Official
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Title or Position | CHRIOPRACTOR
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Name | DR. LAWRENCE ANDEW ROSS
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Credential | D.C.
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Telephone | 772-409-4774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH5388
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License Number State | FL
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