Provider Demographics
NPI:1326479254
Name:WRYK, MONICA (OD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:WRYK
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 1:13330 LANOUE ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:N8N5E1
Mailing Address - Country:CA
Mailing Address - Phone:519-979-0030
Mailing Address - Fax:
Practice Address - Street 1:13330 LANOUE ST
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:ONTARIO
Practice Address - Zip Code:N8N5E1
Practice Address - Country:CA
Practice Address - Phone:519-979-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004792152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist