Healthcare Provider Details

I. General information

NPI: 1992418859
Provider Name (Legal Business Name): NATHAN PAUL RITCHEY II
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6475 PECK RD
RAVENNA OH
44266-8884
US

IV. Provider business mailing address

6475 PECK RD
RAVENNA OH
44266-8884
US

V. Phone/Fax

Practice location:
  • Phone: 330-687-3680
  • Fax:
Mailing address:
  • Phone: 330-687-3680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number187052
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: