Organization
FAYETTE REGIONAL EYECARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN EDWARD ROSS OD (OPTOMETRIST -OWNER/PRESIDENT/SECRET)
(724) 437-1300
Entity
Organization
Contact information
Practice address
160 WAYLAND SMITH DRIVE, SUITE 100, UNIONTOWN, PA 15401
(724) 437-1300
(724) 437-5456
Mailing address
160 WAYLAND SMITH DRIVE, SUITE 100, UNIONTOWN, PA 15401
(724) 437-1300
(724) 437-5456
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OE6001711
PA
152W00000X
Optometrist
OEG001664
PA
152W00000X
Optometrist
OEG001711
PA
Other
Enumeration date
10/14/2006
Last updated
03/11/2011
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