Provider Demographics
NPI:1629148358
Name:RYTHER, MYRON ALLEN (OD)
Entity Type:Individual
Prefix:
First Name:MYRON
Middle Name:ALLEN
Last Name:RYTHER
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 1:501 S WHITE ST STE 21
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2600
Mailing Address - Country:US
Mailing Address - Phone:319-385-2020
Mailing Address - Fax:319-385-6784
Practice Address - Street 1:501 S WHITE ST STE 21
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2600
Practice Address - Country:US
Practice Address - Phone:319-385-2020
Practice Address - Fax:319-385-6784
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1765152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0206940001OtherDMERC
IA0149674Medicaid
IA0149674Medicaid
IA00842Medicare ID - Type Unspecified