Provider Demographics
NPI:1083878235
Name:THACKER SWINDLER, RYANN ROCHELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:RYANN
Middle Name:ROCHELLE
Last Name:THACKER SWINDLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 RIVER ST
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-5900
Mailing Address - Country:US
Mailing Address - Phone:740-645-2135
Mailing Address - Fax:
Practice Address - Street 1:3524 STATE ROUTE 160
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-9681
Practice Address - Country:US
Practice Address - Phone:740-446-2236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5824152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist