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Individual

DR. ELIZABETH ANN RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
142 NORTH MAIN STREET, BELCHERTOWN, MA 01007
(413) 323-1196
(413) 323-1186
Mailing address
142 N MAIN ST, BELCHERTOWN, MA 01007-9433
(413) 323-1196
(413) 323-1186

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
002412
CT
152W00000X
Optometrist
Primary
3455
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0356166
MA
Enumeration date
10/26/2006
Last updated
10/13/2011
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