Provider Demographics
NPI:1205196763
Name:TREECE, ANDREW RYAN (OD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:RYAN
Last Name:TREECE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 E INNES ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28146-6027
Mailing Address - Country:US
Mailing Address - Phone:704-702-6974
Mailing Address - Fax:
Practice Address - Street 1:1808 E INNES ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-6027
Practice Address - Country:US
Practice Address - Phone:704-702-6974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2305152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist