Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | OTA006495 | OH |
NPI | 1013675727 |
---|---|
Provider Name | Ryan Michael Rickard |
First Address | Middletown, OH 45044-9662 |
Second Address | Hamilton, OH 45013-1963 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2021 |
Last Update Date | 30/11/2021 |