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Individual

ROSS JAY SHOTER

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1950 OLD GALLOWS RD, #100, VIENNA, VA 22182-3990
(703) 847-8899
Mailing address
18111 TOWN CENTER DR, OLNEY, MD 20832-1479

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001113
VA
152W00000X
Optometrist
OP823
DC
152W00000X
Optometrist
TA1631
MD

Other

Enumeration date
06/13/2006
Last updated
07/08/2007
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