Individual
KEYDRON DWANE DEROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD DOCTOR OF OPTOMET
Contact information
Practice address
1275 NORTH HERMITAGE ROAD, WALMART VISION CENTER, HERMITAGE, PA 16148
(724) 346-5950
(724) 342-6246
Mailing address
6599 WEST MIDDLETOWN ROAD, CANFIELD, OH 44406-9417
(330) 702-8855
(330) 702-8855
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
3165T405
OH
152W00000X
Optometrist
Primary
4976P
PA
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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