Brack, Ryan Wayne
Brack, Ryan Wayne is an sole proprietor health care provider with primary practice located at 24833 John T Reid Pkwy , Scottsboro AL 35768-2340. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Brack, Ryan Wayne can be contacted via phone (256) 574-5698.Contact Information
Primary practice address
24833 John T Reid Pkwy
Scottsboro AL 35768-2340
Phone: (256) 574-5698
Fax: (256) 574-6939
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | S975TA537 | Alabama |
Profile Details
| NPI number | 1609973379 |
|---|---|
| LBN Legal business name | Brack, Ryan Wayne |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 17th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609973379 | NPPES |
| Alabama | Other | 51503656 | BCBS OF AL |
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