Individual
MR. JOHN ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
520 EAGLE BLVD, KINGSLAND, GA 31548-6569
(843) 709-5271
Mailing address
520 EAGLE BLVD, KINGSLAND, GA 31548-6569
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
LDO002127
GA
Other
Enumeration date
03/05/2009
Last updated
03/05/2009
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