Provider Demographics
NPI:1790193597
Name:RYFF, KYLE (OD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:
Last Name:RYFF
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 1:1920 E BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1511
Mailing Address - Country:US
Mailing Address - Phone:800-233-3264
Mailing Address - Fax:480-345-5266
Practice Address - Street 1:1920 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1511
Practice Address - Country:US
Practice Address - Phone:800-233-3264
Practice Address - Fax:480-345-5266
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-25
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2057152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist