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General NPI Number Information
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NPI Number | 1992055966
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Entity Type | Organization
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Legal Business Name | RYAN LEBLANC OD PLLC
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Dates
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Enumeration Date | 09/17/2012
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 7735 N TRYON ST
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City | CHARLOTTE
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State | NC
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Zip | 28262-3498
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Country | US
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Telephone | 704-547-0305
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Fax |
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Provider Business Mailing Address
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Address Line | 505 IVERSON WAY
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City | CHARLOTTE
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State | NC
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Zip | 28203-5634
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Country | US
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Telephone | 704-555-5555
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Fax | 704-547-0940
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. RYAN LEBLANC
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Credential |
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Telephone | 434-917-1220
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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 | 2159
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License Number State | NC
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