Provider Demographics
NPI:1922746262
Name:SCALES, RICKY
Entity Type:Individual
Prefix:
First Name:RICKY
Middle Name:
Last Name:SCALES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 STATE ROUTE 59
Mailing Address - Street 2:30
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240
Mailing Address - Country:US
Mailing Address - Phone:330-552-4000
Mailing Address - Fax:
Practice Address - Street 1:2500 STATE ROUTE 59
Practice Address - Street 2:30
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240
Practice Address - Country:US
Practice Address - Phone:330-552-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.163706.MEDS.IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse