NPI 1255856845

Ryan G Weaver, LOABOCNCLEC

Practitioner Optician Putnam, CT

Practice location

Address: 625 School St, Putnam, CT 06260-2424
Phone: (860) 630-4634
Fax: (860) 928-4975

Registered specialties

Optician Primary

Eye and Vision Services Providers Taxonomy 156FX1800X Licence 1758 (CT)

Other Technician/Technologist providers in Connecticut →

Registry record

NPI: 1255856845
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Aug 2017
Record last updated: 21 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.