Basic Information
| Provider Information | |||||||||
| NPI: | 1659740025 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RITCHEY | ||||||||
| FirstName: | ROWAN | ||||||||
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| Credential: | MS, AT, ATC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2403 STATE HIGHWAY 294 | ||||||||
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| City: | HARPSTER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 433239381 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193108678 | ||||||||
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| Practice Location | |||||||||
| Address1: | 885 N SANDUSKY AVE | ||||||||
| Address2: | |||||||||
| City: | UPPER SANDUSKY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 433511098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192944991 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2015 | ||||||||
| LastUpdateDate: | 07/22/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2255A2300X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.