Provider Demographics
NPI:1851309140
Name:ROSS, CHRISTOPHER SCOTT (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:ROSS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 CLEAR LAKE DR
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-8153
Mailing Address - Country:US
Mailing Address - Phone:502-492-0774
Mailing Address - Fax:
Practice Address - Street 1:1800 BLUEGRASS AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1130
Practice Address - Country:US
Practice Address - Phone:502-361-2301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R3392225X00000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist