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Organization

ASHE OPTOMETRIC EYECARE CENTER, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN OLIVER RYAN JR. O.D. (PRESIDENT)
(336) 246-8863
Entity
Organization

Contact information

Practice address
306 JEFFERSON AVE, WEST JEFFERSON, NC 28694
(336) 246-8863
(336) 246-8864
Mailing address
PO BOX 1477, WEST JEFFERSON, NC 28694
(336) 246-8863
(336) 246-8864

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1174
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09820
BLUE CROSS BLUE SHEILD
NC
01
10346-1
MEDPOINT
NC
01
56162
MEDCOST
NC
05
8909820
NC
Enumeration date
02/27/2008
Last updated
09/09/2008
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