Provider Demographics
NPI:1144415019
Name:DR JUSTIN ROSS PLC
Entity Type:Organization
Organization Name:DR JUSTIN ROSS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:COLLIN
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:602-867-7463
Mailing Address - Street 1:3120 W CAREFREE HWY
Mailing Address - Street 2:SUITE 1-342
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85086-3201
Mailing Address - Country:US
Mailing Address - Phone:623-223-1350
Mailing Address - Fax:
Practice Address - Street 1:34406 N 27TH DR
Practice Address - Street 2:SUITE 116
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-6082
Practice Address - Country:US
Practice Address - Phone:623-223-1350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty