Individual
RYAN RICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
24 HOMESTEAD AVE, WHEELING, WV 26003-6638
(304) 232-1020
Mailing address
24 HOMESTEAD AVE, WHEELING, WV 26003-6638
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
563
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
563
WV STATE LICENSE
WV
Enumeration date
03/06/2012
Last updated
03/06/2012
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