Doctor Name: | JAYCOB MICHEL ROSS |
NPI Number: | 1487930368 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T. |
License Number: | 8850 |
Business Practice Address: | 2954 Rodeo Park Dr W Santa Fe, NM - 875056351 |
Business Phone Number: | 5054240131 |
Business Fax Number: | |
Mailing Address: | Po Box 6100, SANTA FE |
State: | NM |
Postal Code: | 875026100 |
Phone Number: | 5054240131 |
Fax Number: | 5054241299 |
NPI Enumeration Date: | 10/24/2011 |
NPI Last Update Date: | 10/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 8850 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |