Provider Demographics
NPI:1972722718
Name:ROSS, JEFFREY C (PT ASSIST)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:C
Last Name:ROSS
Suffix:
Gender:M
Credentials:PT ASSIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-8503
Mailing Address - Country:US
Mailing Address - Phone:610-798-9820
Mailing Address - Fax:
Practice Address - Street 1:724 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1108
Practice Address - Country:US
Practice Address - Phone:610-691-6700
Practice Address - Fax:610-814-2789
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATE0065042251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics