MEDICARE: DR. KURT L ROSS DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CH8356	FL

General Provider Information

NPI Number	:	1295892594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KURT L ROSS DC

Provider Business Mailing Address
First Line	:	3015 CASA RIO CT
Second Line	:
City	:	RIVIERA BEACH
State	:	FL
Zip	:	33418-6508
Country	:	US
Telephone Number	:	561-776-7270
Fax Number	:	561-776-1960

Provider Business Practice Location Address
First Line	:	9121 N MILITARY TRL
Second Line	:	SUITE 104
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33410-5984
Country	:	US
Telephone Number	:	561-776-7270
Fax Number	:	561-776-1960

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	07/08/2007

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