Individual
RYAN SACKSTEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
148 13TH ST SW, LARGO, FL 33770-3127
(727) 581-8706
(727) 586-3743
Mailing address
148 13TH ST SW, LARGO, FL 33770-3127
(727) 581-8706
(727) 586-3743
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC4734
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006480900
—
FL
Enumeration date
08/17/2012
Last updated
08/13/2013
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