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NPI Code Detail

MEDICARE: MR. MARK ALLAN RITTER OTR/L

MEDICARE: MR. MARK ALLAN RITTER OTR/L
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
1225XH1200XHand Occupational Therapist2123AZ
2225XN1300XNeurorehabilitation Occupational Therapist2123AZ
3225XR0403XDriving and Community Mobility Occupational Therapist2123AZ

General Provider Information

NPI Number : 1184885394
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK ALLAN RITTER OTR/L
Provider Business Mailing Address
First Line : 505 JACKS CANYON RD
Second Line :
City : SEDONA
State : AZ
Zip : 86351-7856
Country : US
Telephone Number : 928-284-2411
Fax Number : 928-284-2439
Provider Business Practice Location Address
First Line : 505 JACKS CANYON RD
Second Line :
City : SEDONA
State : AZ
Zip : 86351-7856
Country : US
Telephone Number : 928-284-2411
Fax Number : 928-284-2439
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 06/19/2008

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