Individual
RICHARD WESLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
1201 S FORT THOMAS AVE, FORT THOMAS, KY 41075-2421
(859) 781-5586
Mailing address
502 FARRELL DR, COVINGTON, KY 41011-3717
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184607
MEDICARE GROUP NUMBER
KY
Enumeration date
07/06/2006
Last updated
07/08/2007
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