Provider Demographics
NPI:1881018885
Name:ROSS, SHANNA (DPT)
Entity Type:Individual
Prefix:DR
First Name:SHANNA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1668 CONNOR RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-9035
Mailing Address - Country:US
Mailing Address - Phone:724-322-2832
Mailing Address - Fax:
Practice Address - Street 1:2020 ARDMORE BLVD
Practice Address - Street 2:SUITE 295
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-4608
Practice Address - Country:US
Practice Address - Phone:412-271-8347
Practice Address - Fax:866-902-6694
Is Sole Proprietor?:No
Enumeration Date:2014-02-11
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023428225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist