Provider Demographics
NPI:1003471269
Name:ASHLEY ROSSMAN EYE CARE
Entity Type:Organization
Organization Name:ASHLEY ROSSMAN EYE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-734-9802
Mailing Address - Street 1:932 SPRING ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2286
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:932 SPRING ST STE 101
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2286
Practice Address - Country:US
Practice Address - Phone:810-734-9802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-03
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty