Individual
DR. RYAN KYLE PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
488 W HOSPITAL RD, PAOLI, IN 47454-8807
(812) 723-4752
(812) 723-4753
Mailing address
488 W HOSPITAL RD, PAOLI, IN 47454-8807
(812) 723-4752
(812) 723-4753
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003259A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200460220A
—
IN
Enumeration date
03/09/2006
Last updated
12/11/2007
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