Individual
DR. CHARLES T RIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1684 N PROSPECT AVE, MILWAUKEE, WI 53202-2408
(414) 271-2020
(414) 272-3932
Mailing address
1684 N PROSPECT AVE, MILWAUKEE, WI 53202-2408
(414) 271-2020
(414) 272-3932
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1141
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38596000
—
WI
01
—
4304775
AETNA
WI
Enumeration date
08/30/2005
Last updated
01/16/2008
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