Provider Demographics
NPI:1902460991
Name:ROSS, VICTORIA (CMAS)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:ROSS
Suffix:
Gender:F
Credentials:CMAS
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:MICHELLE
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:96B TOMMY STALNAKER DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-9179
Mailing Address - Country:US
Mailing Address - Phone:478-718-7970
Mailing Address - Fax:478-718-7970
Practice Address - Street 1:96B TOMMY STALNAKER DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9179
Practice Address - Country:US
Practice Address - Phone:478-718-7970
Practice Address - Fax:478-718-7970
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator