Individual
RYAN VICKNAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8036 POST OAK PL, LOUISVILLE, KY 40222-6835
(502) 852-7122
Mailing address
8036 POST OAK PL, LOUISVILLE, KY 40222-6835
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1181
KY
Other
Enumeration date
04/09/2015
Last updated
04/09/2015
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