Individual
BRYNA LEE RICKENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-A
Contact information
Practice address
1705 WARREN AVE, SUITE 204-205, WILLIAMSPORT, PA 17701-2647
(570) 320-7474
(570) 320-7479
Mailing address
1201 GRAMPIAN BLVD, SUITE 1K, WILLIAMSPORT, PA 17701-1900
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
2201001520
VA
231H00000X
Audiologist
Primary
AT006327
PA
237600000X
Audiologist-Hearing Aid Fitter
AT006327
PA
Other
Enumeration date
06/20/2013
Last updated
11/05/2014
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