Provider Demographics
NPI:1538223177
Name:RITCH, RALPH DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:DAVID
Last Name:RITCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 E MAIN ST
Mailing Address - Street 2:P O BOX 131
Mailing Address - City:FULTON
Mailing Address - State:MS
Mailing Address - Zip Code:38843-2004
Mailing Address - Country:US
Mailing Address - Phone:662-862-9239
Mailing Address - Fax:662-862-9239
Practice Address - Street 1:508 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:MS
Practice Address - Zip Code:38843-2004
Practice Address - Country:US
Practice Address - Phone:662-862-9239
Practice Address - Fax:662-862-9239
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS343111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MST20754Medicare UPIN