Individual
MR. NICKOLAS VINCENT MINOR RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3095 KETTERING BLVD, MORAINE, OH 45439-1983
(937) 293-8300
Mailing address
3520 POBST DR, KETTERING, OH 45420-1044
(937) 477-4331
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN.445733
OH
Other
Enumeration date
11/17/2010
Last updated
10/03/2019
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