MRS. Alicia Sue Ross

NPI #1326413055 in Star Lake, New York

Provider Information

NPI Number: 1326413055
Entity Type: Individual
Name: MRS. Alicia Sue Ross
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Dec 7, 2015
Last Updated: Dec 7, 2015

Practice Location

Address: 21 CHERRY HILL RD
City: Star Lake
State: New York
ZIP Code: 13690-3145
Phone: (315) 405-2871

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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