Individual
RYAN LANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2504 LARKIN RD, APT. 249, LEXINGTON, KY 40503-3209
(859) 245-1832
Mailing address
2504 LARKIN RD, APT. 249, LEXINGTON, KY 40503-3209
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
10/20/2014
Last updated
10/21/2014
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