Basic Information
| Provider Information | |||||||||
| NPI: | 1811981137 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RITCHIE | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | DAVID | ||||||||
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| Credential: | A.T.,C. , PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 122 PAIGE LN | ||||||||
| Address2: | |||||||||
| City: | ELKTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 219217631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103926096 | ||||||||
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| Practice Location | |||||||||
| Address1: | 304-306 NORTH STREET STREET | ||||||||
| Address2: | SUITE 4 | ||||||||
| City: | ELKTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103925550 | ||||||||
| FaxNumber: | 4103986062 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2255A2300X | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer |
No ID Information.