Individual
DR. RYAN ALEXANDER NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
574 N US HIGHWAY 441, LADY LAKE, FL 32159-3776
(352) 350-5298
Mailing address
2524 SAINT IGNATIUS CT, ORLANDO, FL 32835-6500
(909) 542-5208
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC5007
FL
Other
Enumeration date
07/08/2014
Last updated
01/20/2015
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