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General NPI Number Information
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NPI Number | 1760180764
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Entity Type | Organization
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Legal Business Name | ROSS PHYSICAL THERAPY & WELLNESS LLC
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 215 W LIPAN DR
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City | LIPAN
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State | TX
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Zip | 76462-2001
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Country | US
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Telephone | 325-716-9443
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 119
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City | LIPAN
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State | TX
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Zip | 76462-0119
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Country | US
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Telephone | 325-716-9443
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | TRACI ROSS
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Credential | PT
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Telephone | 325-716-9443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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