Individual
RICKY L. SCALCUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D
Contact information
Practice address
800 1ST ST, WAUSAU, WI 54403-4754
(715) 261-8500
(715) 261-8665
Mailing address
800 1ST ST, WAUSAU, WI 54403-4754
(715) 261-8500
(715) 261-8665
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2204
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38576100
—
WI
Enumeration date
11/25/2005
Last updated
10/07/2020
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