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Individual

DR. RYAN LIVESAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
5959 POPLAR AVE, MEMPHIS, TN 38119-3938
(901) 821-5475
Mailing address
750 N GERMANTOWN PKWY STE 108, CORDOVA, TN 38018-2303
(901) 758-9000

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3783
TN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
11/03/2022
Last updated
11/22/2022
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