Individual
RICO COPASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
228 BEEMAN PL, FORT RILEY, KS 66442-7009
(785) 239-7390
Mailing address
228 BEEMAN PL, FORT RILEY, KS 66442-7009
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
04/05/2022
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