Individual
MATTHEW DAVID RUZICKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4 S MARKET ST, TROY, OH 45373-3218
(937) 339-2020
(937) 339-2332
Mailing address
4 S MARKET ST, TROY, OH 45373-3218
(937) 339-2020
(937) 339-2332
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OH 5090 / T 1969
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000353804
ANTHEM
—
Enumeration date
10/16/2006
Last updated
02/17/2014
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