Healthcare Provider Details

I. General information

NPI: 1306701958
Provider Name (Legal Business Name): KRISTI LEE RITTER-PEACOCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTI LEE RITTER

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N LAKE DR
LEXINGTON SC
29072-2903
US

IV. Provider business mailing address

7 CARNEGIE PLZ
CHERRY HILL NJ
08003-1000
US

V. Phone/Fax

Practice location:
  • Phone: 877-407-3422
  • Fax:
Mailing address:
  • Phone: 877-407-3422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2113
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: