Individual
MR. RICKY LYNN WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
510 BUTLER AVE, MARTINSBURG, WV 25405-9990
(304) 262-0811
(304) 262-1292
Mailing address
510 BUTLER AVE, MARTINSBURG, WV 25405-9990
(304) 263-0811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110-001492
VA
Other
Enumeration date
01/12/2006
Last updated
07/16/2007
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