Individual
RICKY DANIEL CARMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3651 HIGHWAY 2565 FL 2, LOUISA, KY 41230-5018
(606) 638-0938
(859) 813-5394
Mailing address
3651 HIGHWAY 2565 FL 2, LOUISA, KY 41230-5018
(606) 638-0938
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30610026
—
KY
Enumeration date
09/06/2012
Last updated
03/11/2016
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