Individual
DR. KELLY G ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1014 W MAIN ST, WALNUT RIDGE, AR 72476-1004
(870) 886-2632
(870) 886-1514
Mailing address
PO BOX 349, WALNUT RIDGE, AR 72476-0349
(870) 886-2632
(870) 886-1514
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2485
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137089722
—
AR
Enumeration date
06/22/2006
Last updated
12/29/2008
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