Healthcare Provider Details

I. General information

NPI: 1043338205
Provider Name (Legal Business Name): ANTHONY RICCI P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 WEST ST SUITE 110
ANNAPOLIS MD
21401-4055
US

IV. Provider business mailing address

1610 WEST ST SUITE 110
ANNAPOLIS MD
21401-4055
US

V. Phone/Fax

Practice location:
  • Phone: 410-263-6331
  • Fax: 410-280-9886
Mailing address:
  • Phone: 410-263-6331
  • Fax: 410-280-9886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number1542 PT
License Number StateMD

VIII. Authorized Official

Name: DR. ANTHONY T. RICCI
Title or Position: PRESIDENT/CHIROPRACTOR
Credential: D.C.
Phone: 410-263-6331