Provider Demographics
NPI:1932428109
Name:ROSS, JOHN ALAN (BS, CNIM)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ALAN
Last Name:ROSS
Suffix:
Gender:M
Credentials:BS, CNIM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9905 N WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64157-1046
Mailing Address - Country:US
Mailing Address - Phone:816-415-4575
Mailing Address - Fax:
Practice Address - Street 1:9905 N WILLOW AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64157-1046
Practice Address - Country:US
Practice Address - Phone:816-415-4575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic