Individual
DR. RYAN K DEIBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3049 S OAKES RD, STURTEVANT, WI 53177-1961
(414) 550-8530
Mailing address
1104 S 74TH ST, WEST ALLIS, WI 53214-3007
(414) 550-8530
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3165-035
WI
Other
Enumeration date
08/14/2009
Last updated
02/18/2010
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