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Individual

RONALD LEE DURRETT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPO

Contact information

Practice address
525 ALEXANDRIA PIKE, SUITE 250, SOUTHGATE, KY 41071-3290
(859) 441-8111
(859) 441-8111
Mailing address
20 MEDICAL VILLAGE DR, SUITE 100, EDGEWOOD, KY 41017-5401
(859) 341-7688
(859) 341-4476

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21755
ABP-SG
KY
Enumeration date
10/12/2006
Last updated
07/08/2007
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