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General NPI Number Information
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NPI Number | 1710321237
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Entity Type | Organization
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Legal Business Name | PATRICIA NEAL ROSS OD OC
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 04/26/2013
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Provider Practice Location Address
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Address Line | HC 89 BOX 421
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City | MC GRAWS
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State | WV
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Zip | 25876-9705
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Country | US
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Telephone | 304-294-7465
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Fax |
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Provider Business Mailing Address
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Address Line | HC 89 BOX 421
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City | MC GRAWS
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State | WV
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Zip | 25876-9705
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Country | US
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Telephone | 304-294-7465
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICIA NEAL ROSS
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Credential | O.D.
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Telephone | 304-294-7465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 772OD
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License Number State | WV
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