Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC001412L | PA |
N | 111NR0400X | Rehabilitation Chiropractor | 001412L | PA |
NPI | 1164483772 |
---|---|
Provider Name | Earl G. Ritter |
First Address | Bloomsburg, PA 17815-3023 |
Second Address | Bloomsburg, PA 17815-3023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 26/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01577901 | CAPITAL BLUE CROSS (01) | PA |
1001294055 | (05) | PA |
115677 | HIGHMARK BLUE SHIELD (01) | PA |