Individual
JOHN V RICKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
103 S CENTER STREET, SUITE D, SUBLIMITY, OR 97385
(503) 769-9181
(503) 769-9182
Mailing address
PO BOX 237, SUBLIMITY, OR 97385-0237
(503) 769-9181
(503) 769-9182
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1724ATI
OR
152W00000X
Optometrist
651
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107185
—
OR
Enumeration date
04/19/2006
Last updated
12/10/2009
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