Provider Demographics
NPI:1932999414
Name:ROSS, RENE NICOLE (DPT, PT)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:NICOLE
Last Name:ROSS
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20347 TIMBERLAKE RD STE B
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-7352
Mailing Address - Country:US
Mailing Address - Phone:540-586-1138
Mailing Address - Fax:434-509-1695
Practice Address - Street 1:3 CEDAR HILL CT STE C
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:VA
Practice Address - Zip Code:24523-6457
Practice Address - Country:US
Practice Address - Phone:540-586-1138
Practice Address - Fax:434-509-1695
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA2305217133208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation