Individual
DR. RYAN MONTGOMERY LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3905 NEW BERN AVE, RALEIGH, NC 27610-1332
(919) 231-6040
(919) 231-6044
Mailing address
3905 NEW BERN AVE, RALEIGH, NC 27610-1332
(919) 231-6040
(919) 231-6044
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618001852
VA
152W00000X
Optometrist
Primary
2159
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0932M
BCBS PROV #
NC
05
—
5914851
—
NC
01
—
AO5134
EYEMED
NC
Enumeration date
06/19/2009
Last updated
08/29/2012
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