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General NPI Number Information
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NPI Number | 1194064584
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Entity Type | Organization
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Legal Business Name | RYAN M. SUBLER, O.D., INC.
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Dates
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Enumeration Date | 02/05/2013
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 1001 S DORSET RD
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City | TROY
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State | OH
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Zip | 45373-4750
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Country | US
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Telephone | 937-339-7446
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Fax | 937-335-6026
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Provider Business Mailing Address
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Address Line | 1001 S DORSET RD
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City | TROY
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State | OH
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Zip | 45373-4750
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Country | US
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Telephone | 937-339-7446
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Fax | 937-335-6026
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RYAN MICHAEL SUBLER
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Credential | O.D.
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Telephone | 614-668-0989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5663T2577
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License Number State | OH
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