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General NPI Number Information
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NPI Number | 1588943476
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Entity Type | Individual
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Provider Name | JOHN NATHAN ROSS L. AC.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 11/30/2012
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Provider Practice Location Address
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Address Line | 285 BANK STREET, # A
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City | WELLFLEET
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State | MA
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Zip | 02667
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Country | US
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Telephone | 508-349-7700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1880 285 BANK STREET, #A
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City | WELLFLEET
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State | MA
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Zip | 02667-1880
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Country | US
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Telephone | 508-349-7700
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0709
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 4401
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 251463
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License Number State | MA
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