Provider Demographics
NPI:1548799109
Name:ROSS, SAVANNAH (PTA)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11420 CLYBOURN AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE VIEW TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:91342-6706
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2580 GANAHL ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-2015
Practice Address - Country:US
Practice Address - Phone:626-644-6336
Practice Address - Fax:323-366-4260
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2024-02-29
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant