Provider Demographics
NPI:1275834111
Name:DR. KARYN L ROSS
Entity Type:Organization
Organization Name:DR. KARYN L ROSS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARYN
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-888-0443
Mailing Address - Street 1:203 SOUTH ST STE D
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:PA
Mailing Address - Zip Code:18810-1146
Mailing Address - Country:US
Mailing Address - Phone:570-888-0443
Mailing Address - Fax:570-888-0437
Practice Address - Street 1:203 SOUTH ST STE D
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:PA
Practice Address - Zip Code:18810-1146
Practice Address - Country:US
Practice Address - Phone:570-888-0443
Practice Address - Fax:570-888-0437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009555111N00000X
PADC010099111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty