Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | J10002070 | DE |
NPI | 1033277603 |
---|---|
Provider Name | Lisa Pozzi Ross |
First Address | Bear, DE 19701 |
Second Address | Wilmington, DE 19802-4722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2006 |
Last Update Date | 16/08/2010 |