Healthcare Provider Details

I. General information

NPI: 1841084977
Provider Name (Legal Business Name): ALLYSON ELIZABETH RITCHEY MS, LAT, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16228 STATE ROAD 54
ODESSA FL
33556-3729
US

IV. Provider business mailing address

5236 LEGENDARY LOOP APT 421
WESLEY CHAPEL FL
33544-8667
US

V. Phone/Fax

Practice location:
  • Phone: 813-475-5599
  • Fax:
Mailing address:
  • Phone: 330-417-6896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL7263
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: