Individual
RYAN CAPOUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5120 PROSPERITY WAY S STE 114, FARGO, ND 58104-7568
(701) 404-9096
(701) 436-9223
Mailing address
5120 PROSPERITY WAY S STE 114, FARGO, ND 58104-7568
(701) 404-9096
(701) 436-9223
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
PENDING
ND
Other
Enumeration date
05/23/2018
Last updated
06/02/2021
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