Healthcare Provider Details

I. General information

NPI: 1205553039
Provider Name (Legal Business Name): BRIGIETT KAY RITCHIE OMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2022
Last Update Date: 10/24/2022
Certification Date: 10/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2062 RICHERT AVE
CLOVIS CA
93611-5236
US

IV. Provider business mailing address

2062 RICHERT AVE
CLOVIS CA
93611-5236
US

V. Phone/Fax

Practice location:
  • Phone: 559-387-9052
  • Fax:
Mailing address:
  • Phone: 559-387-9052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number24658
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: