Individual
DR. BRIAN MATTHEW ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
643 OHIO ST, TERRE HAUTE, IN 47807-3525
(812) 232-0073
(812) 232-0074
Mailing address
9795 CROSSPOINT BLVD, SUITE 100, INDIANAPOLIS, IN 46256-3354
(317) 254-6480
(317) 259-8609
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003235A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200444580
—
IN
Enumeration date
08/30/2005
Last updated
09/09/2014
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