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General NPI Number Information
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NPI Number | 1407425754
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Entity Type | Organization
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Legal Business Name | DR CHELSEA RYZUK
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 579 FOLLY RD STE 14083
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City | CHARLESTON
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State | SC
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Zip | 29412-3005
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Country | US
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Telephone | 843-481-5459
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Fax |
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Provider Business Mailing Address
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Address Line | 579 FOLLY RD STE 14083
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City | CHARLESTON
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State | SC
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Zip | 29412-3005
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Country | US
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Telephone | 843-481-5459
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | CHELSEA RYZUK
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Credential |
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Telephone | 631-235-5050
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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 |
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License Number State |
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