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Individual

DR. DAN JOHN HYDUCHAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
914 SW HURBERT ST, NEWPORT, OR 97365-4715
(541) 265-2020
(541) 265-8988
Mailing address
914 SW HURBERT ST, NEWPORT, OR 97365-4715
(541) 265-2020
(541) 265-8988

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3027ATI
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3027ATI
OREGON OPTOMETRY LICENSE
OR
Enumeration date
01/24/2007
Last updated
11/01/2007
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