Healthcare Provider Details

I. General information

NPI: 1316055684
Provider Name (Legal Business Name): RICKY DAVID HOWARD DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3616 HOLMAN LANE
JEFFERSONVILLE IN
47130
US

IV. Provider business mailing address

3616 HOLMAN LANE
JEFFERSONVILLE IN
47130
US

V. Phone/Fax

Practice location:
  • Phone: 812-288-4660
  • Fax: 812-288-4628
Mailing address:
  • Phone: 812-288-4660
  • Fax: 812-288-4628

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number08000856A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4185
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: