Provider Demographics
NPI:1346563160
Name:OSBORNE, ROSS T (BC HIS)
Entity Type:Individual
Prefix:MR
First Name:ROSS
Middle Name:T
Last Name:OSBORNE
Suffix:
Gender:M
Credentials:BC HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 HATCHER LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-4826
Mailing Address - Country:US
Mailing Address - Phone:931-381-5300
Mailing Address - Fax:931-381-8974
Practice Address - Street 1:900 BOB WALLACE AVE SW STE 108
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5647
Practice Address - Country:US
Practice Address - Phone:256-539-4009
Practice Address - Fax:256-539-4034
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000458237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist