Individual
NICHOLAS RYAN MAIROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
20 FERGUSON BLVD, DRY RIDGE, KY 41035-8699
(859) 824-0724
(859) 824-0734
Mailing address
20 FERGUSON BLVD, DRY RIDGE, KY 41035-8699
(859) 824-0724
(859) 824-0734
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
110747
KY
Other
Enumeration date
09/20/2024
Last updated
09/20/2024
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