Organization
RYAN PETERSON O.D., INC.
Active
Other names
FAMILY FOCUSED EYECARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN KENT PETERSON O.D. (OWNER)
(702) 644-6671
Entity
Organization
Contact information
Practice address
5691 RICKENBACKER RD, NELLIS AFB, NV 89191-7052
(702) 644-6671
(702) 644-6682
Mailing address
PO BOX 9792, NELLIS AFB, NV 89191-0792
(702) 644-6671
(702) 444-0264
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
532
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100506817
—
NV
05
—
100508599
—
NV
Enumeration date
07/14/2006
Last updated
05/05/2021
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