Individual
RICO A SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3449 COLONY LAKE CT, CANAL WINCHESTER, OH 43110-8724
(614) 307-9689
Mailing address
3449 COLONY LAKE CT, CANAL WINCHESTER, OH 43110-8724
(614) 307-9689
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
RL83472
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421434
—
OH
Enumeration date
06/13/2019
Last updated
06/13/2019
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