Healthcare Provider Details

I. General information

NPI: 1801906334
Provider Name (Legal Business Name): ANTHONY T RICCI D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/20/2010
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:
Title or Position:
Credential:
Phone: