Provider Demographics
NPI:1205985918
Name:RITCHIE, KENNETH T (PT)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:T
Last Name:RITCHIE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 HEACOCK RD
Mailing Address - Street 2:SUITE 200A
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-6346
Mailing Address - Country:US
Mailing Address - Phone:215-321-6989
Mailing Address - Fax:215-321-7217
Practice Address - Street 1:680 HEACOCK RD
Practice Address - Street 2:SUITE 200A
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-6346
Practice Address - Country:US
Practice Address - Phone:215-321-6989
Practice Address - Fax:215-321-7217
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT004069L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARI002690Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER