Organization
PHILLIP B TICKNER OD & ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP BRYAN TICKNER OD (OD)
(205) 919-0671
Entity
Organization
Contact information
Practice address
8551 WHITFIELD AVE, LEEDS, AL 35094-7560
(205) 699-0719
(205) 699-0722
Mailing address
109 ANDERSON CIR, TRUSSVILLE, AL 35173-1001
(205) 919-0671
(205) 739-2027
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
SB65TA769
AL
Other
Enumeration date
11/06/2009
Last updated
05/18/2010
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