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NPI Code Detail

MEDICARE: MR. RYAN J RITCHHART PA-C

MEDICARE:  MR. RYAN J RITCHHART  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant2588AZ
2363A00000XPhysician Assistant2432CO

Other Identifiers

General Provider Information

NPI Number : 1053314310
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RYAN J RITCHHART PA-C
Provider Business Mailing Address
First Line : 1551 PROFESSIONAL LN UNIT 200
Second Line :
City : LONGMONT
State : CO
Zip : 80501-6964
Country : US
Telephone Number : 303-772-1600
Fax Number : 303-772-9317
Provider Business Practice Location Address
First Line : 1551 PROFESSIONAL LN UNIT 200
Second Line :
City : LONGMONT
State : CO
Zip : 80501-6964
Country : US
Telephone Number : 303-772-1600
Fax Number : 303-772-9317
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2005
Last Update Date : 12/22/2014

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Directions to “ MR. RYAN J RITCHHART PA-C” Practice Location

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