Basic Information
Provider Information
NPI: 1336262609
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROSS
FirstName: CYNTHIA
MiddleName: SCARBROUGH
NamePrefix:  
NameSuffix:  
Credential: L.P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ROSS
OtherFirstName: CINDY
OtherMiddleName: S
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: L.P.T.
OtherLastNameType: 5
Mailing Information
Address1: 170 TAYLOR STATION RD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432134441
CountryCode: US
TelephoneNumber: 6145457910
FaxNumber: 6145457901
Practice Location
Address1: 170 TAYLOR STATION RD
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432134441
CountryCode: US
TelephoneNumber: 6145457910
FaxNumber: 6145457901
Other Information
ProviderEnumerationDate: 04/09/2007
LastUpdateDate: 02/25/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X3702OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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