Individual
DR. JEFFREY RYAN WIEDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1100 MAIN ST, FORT MORGAN, CO 80701-2036
(806) 336-7105
Mailing address
1100 MAIN ST, FORT MORGAN, CO 80701-2036
(806) 336-7105
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2664
CO
Other
Enumeration date
09/11/2008
Last updated
11/30/2017
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