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General NPI Number Information
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NPI Number | 1063469526
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Entity Type | Individual
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Provider Name | OMAR A ROSS P.T.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2591 WEXFORD BAYNE RD SUITE 107
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City | SEWICKLEY
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State | PA
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Zip | 15143-8676
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Country | US
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Telephone | 724-934-1988
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Fax | 724-934-1999
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Provider Business Mailing Address
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Address Line | 2591 WEXFORD BAYNE RD SUITE 107
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City | SEWICKLEY
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State | PA
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Zip | 15143-8676
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Country | US
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Telephone | 724-934-1988
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Fax | 724-934-1999
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT017722
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License Number State | PA
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