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Individual
TODD RYAN DIMMICK
Active
Individual
TODD RYAN DIMMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002688
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OEG002688
LICENSE
PA
Enumeration date
07/26/2012
Last updated
07/29/2013
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