DR. Ryan Tyler Fullen, OD

NPI #1245528389 in Manning, South Carolina

Provider Information

NPI Number: 1245528389
Entity Type: Individual
Name: DR. Ryan Tyler Fullen, OD
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: OD
Enumeration Date: Jul 11, 2011
Last Updated: Mar 3, 2015

Practice Location

Address: 1774 PAXVILLE HWY
City: Manning
State: South Carolina
ZIP Code: 29102-5071
Phone: (803) 435-2494

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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