Organization
RYAN NICHOLAS OD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN NICHOLAS OD (OPTOMETRIST)
(909) 542-5208
Entity
Organization
Contact information
Practice address
4200 CONROY RD # B166, ORLANDO, FL 32839-2400
(407) 473-3539
(407) 796-8602
Mailing address
5268 BASKIN ST, ORLANDO, FL 32814-6920
(909) 542-5208
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
11/02/2019
Last updated
11/02/2019
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