Provider Demographics
NPI:1225287766
Name:BROSS, JOSHUA GARY (DC, MS, CSCS)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:GARY
Last Name:BROSS
Suffix:
Gender:M
Credentials:DC, MS, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10716 SYMPHONY WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-4924
Mailing Address - Country:US
Mailing Address - Phone:310-488-0303
Mailing Address - Fax:
Practice Address - Street 1:6325 WOODSIDE CT
Practice Address - Street 2:SUITE 225
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1017
Practice Address - Country:US
Practice Address - Phone:443-718-9432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30942111N00000X
MD03553111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor