Provider Demographics
NPI:1063469526
Name:ROSS, OMAR A (PT)
Entity Type:Individual
Prefix:MR
First Name:OMAR
Middle Name:A
Last Name:ROSS
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:2591 WEXFORD BAYNE RD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8676
Mailing Address - Country:US
Mailing Address - Phone:724-934-1988
Mailing Address - Fax:724-934-1999
Practice Address - Street 1:2591 WEXFORD BAYNE RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8676
Practice Address - Country:US
Practice Address - Phone:724-934-1988
Practice Address - Fax:724-934-1999
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAPT017722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist