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General NPI Number Information
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NPI Number | 1326479254
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Entity Type | Individual
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Provider Name | MONICA WRYK O.D.
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Gender | Female
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 13330 LANOUE ST
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City | TECUMSEH
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State | ONTARIO
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Zip | N8N5E1
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Country | CA
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Telephone | 519-979-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 13330 LANOUE ST
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City | TECUMSEH
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State | ONTARIO
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Zip | N8N5E1
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Country | CA
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Telephone | 519-979-0030
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4901004792
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License Number State | MI
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