Individual
RYAN RIVARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
324 SOUTHVIEW DR, NICHOLASVILLE, KY 40356-2008
(859) 227-6663
Mailing address
1602 JENNIFER RD APT 23, LEXINGTON, KY 40505-3010
(859) 227-6663
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
02/28/2017
Last updated
03/09/2017
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