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1205200490
MARK ROSS
MILWAUKEE, WI
NPI
1205200490
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-11-25
Last Update Date
2015-11-25
Business Address
Mr. MARK ROSS SAC-IT
5408 N 40TH ST
MILWAUKEE, WI 53209-4618
Phone number: 414-881-2342
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Mailing Address
Mr. MARK ROSS SAC-IT
5408 N 40TH ST
MILWAUKEE, WI 53209-4618
Phone number: 414-881-2342
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