Healthcare Provider Details

I. General information

NPI: 1881651065
Provider Name (Legal Business Name): RALPH M. GARVIN A,T,.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12307 MIDLAND TRAIL RD
ASHLAND KY
41102-9639
US

IV. Provider business mailing address

4821 KILDEE DR
ASHLAND KY
41102-8519
US

V. Phone/Fax

Practice location:
  • Phone: 606-928-7101
  • Fax:
Mailing address:
  • Phone: 606-928-4341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT529
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number231-P
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: