Individual
DR. JESSE ROSSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441-6200
(763) 545-8850
(763) 544-1257
Mailing address
10600 OLD COUNTY ROAD 15, PLYMOUTH, MN 55441-6200
(763) 545-8850
(763) 544-1257
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3330
MN
152WC0802X
Corneal and Contact Management Optometrist
3330
MN
152WP0200X
Pediatric Optometrist
3330
MN
Other
Enumeration date
05/30/2013
Last updated
05/31/2013
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