Individual
DR. ROSS C WORTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
400 E ADAMS AVE, RIVERTON, WY 82501-4413
(307) 856-6531
(307) 856-1306
Mailing address
400 E ADAMS AVE, RIVERTON, WY 82501-4413
(307) 856-6531
(307) 856-1306
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T197
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102280600
—
WY
Enumeration date
12/01/2005
Last updated
01/09/2015
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