Provider Demographics
NPI:1174772206
Name:ROSS, LINDA HOWELL
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:HOWELL
Last Name:ROSS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:LINDA
Other - Last Name:HOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9424 BETHANY PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-1262
Mailing Address - Country:US
Mailing Address - Phone:240-477-4562
Mailing Address - Fax:
Practice Address - Street 1:4961 NICHOLSON CT
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-1004
Practice Address - Country:US
Practice Address - Phone:301-881-2273
Practice Address - Fax:301-881-3880
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21063225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist