Ryan Shake, O.D.

NPI #1457707911 in Myrtle Beach, South Carolina

Provider Information

NPI Number: 1457707911
Entity Type: Individual
Name: Ryan Shake, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: May 13, 2016
Last Updated: May 13, 2016

Practice Location

Address: 2000 COASTAL GRAND CIR
City: Myrtle Beach
State: South Carolina
ZIP Code: 29577-9798
Phone: (843) 444-0900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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