=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558609263
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEBORAH L RITCHEY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/30/2013
-----------------------------------------------------
Last Update Date | 01/30/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4863 MIDDLE RD
-----------------------------------------------------
City | HONEY GROVE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17035-7270
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-734-3610
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4863 MIDDLE RD
-----------------------------------------------------
City | HONEY GROVE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17035-7270
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | TEI001509
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------