Individual
RICKY MCDANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
697 MADISON AVENUE, MADISON, WV 25130
(304) 369-8826
Mailing address
701 MADISON AVE, MADISON, WV 25130-1699
(304) 369-1230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1112738
WV
Other
Enumeration date
05/19/2014
Last updated
07/20/2026
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