Provider Demographics
NPI:1679887392
Name:ROSS, VICTORIA SHIHOMI (PT, DPT, CI, ATC)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:SHIHOMI
Last Name:ROSS
Suffix:
Gender:F
Credentials:PT, DPT, CI, ATC
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:SHIHOMI
Other - Last Name:RATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT, CI, ATC
Mailing Address - Street 1:2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER
Mailing Address - Street 2:
Mailing Address - City:FORT LIBERTY
Mailing Address - State:NC
Mailing Address - Zip Code:28310-0001
Mailing Address - Country:US
Mailing Address - Phone:910-907-8922
Mailing Address - Fax:910-907-6069
Practice Address - Street 1:2817 ROCK MERRITT AVE WOMACK ARMY MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:FORT LIBERTY
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-907-8922
Practice Address - Fax:910-907-6069
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009592225100000X
2251S0007X
UT8160250-2401225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports