Provider Demographics
NPI:1174774442
Name:ROSS, CORLAS ANN (PTA)
Entity type:Individual
Prefix:
First Name:CORLAS
Middle Name:ANN
Last Name:ROSS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7 S ALLIANCE DR STE 102A
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-7271
Mailing Address - Country:US
Mailing Address - Phone:843-560-2303
Mailing Address - Fax:843-569-2304
Practice Address - Street 1:7 S ALLIANCE DR STE 102A
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-7271
Practice Address - Country:US
Practice Address - Phone:843-560-2303
Practice Address - Fax:843-569-2304
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant