Provider Demographics
NPI:1245800408
Name:RYAN, CARLEE (OD)
Entity type:Individual
Prefix:DR
First Name:CARLEE
Middle Name:
Last Name:RYAN
Suffix:
Gender:
Credentials:OD
Other - Prefix:DR
Other - First Name:CARLEE
Other - Middle Name:
Other - Last Name:BALZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:950 EDELWEISS VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-7441
Mailing Address - Country:US
Mailing Address - Phone:989-732-5233
Mailing Address - Fax:989-732-5344
Practice Address - Street 1:950 EDELWEISS VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-7441
Practice Address - Country:US
Practice Address - Phone:989-732-5233
Practice Address - Fax:989-732-5344
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005555152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist