MR. Ryan Wayne Brack, O.D.

NPI #1609973379 in Scottsboro, Alabama

Provider Information

NPI Number: 1609973379
Entity Type: Individual
Name: MR. Ryan Wayne Brack, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Sep 17, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 24833 JOHN T REID PKWY
City: Scottsboro
State: Alabama
ZIP Code: 35768-2340
Phone: (256) 574-5698

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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