| NPI | 1154980811 |
|---|---|
| Former Legal Business Name | SUSAN ROSS OD PROFESSIONAL CORPORATION |
| Entity Type | Organization |
| Authorized Contact | MELISSA ALLISON Sr. Director Rcm/Mvc 314-741-8183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2023-07-18 |