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NPI Code Detail

MEDICARE: SHANDA RITTER

MEDICARE: SHANDA RITTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy AssistantTX

General Provider Information

NPI Number : 1881966570
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANDA RITTER
Provider Business Mailing Address
First Line : 4109 HIGHWAY 98 W
Second Line :
City : SUMMIT
State : MS
Zip : 39666-9132
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 111 RUTHLYNN DR
Second Line :
City : LONGVIEW
State : TX
Zip : 75605-5635
Country : US
Telephone Number : 903-238-9198
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2012
Last Update Date : 01/27/2012

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Directions to “ SHANDA RITTER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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