Individual
RYAN P. TETTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
21 PARK PL, APPLETON, WI 54914-8872
(920) 739-4361
(920) 739-6368
Mailing address
21 PARK PL, APPLETON, WI 54914-8872
(920) 739-4361
(920) 739-6368
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3120-035
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001845140
MEDICARE
WI
Enumeration date
08/15/2008
Last updated
03/26/2013
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