Basic Information
Provider Information
NPI: 1851717201
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RITCHIE
FirstName: SARAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOWELL
OtherFirstName: SARAH
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: DPT
OtherLastNameType: 1
Mailing Information
Address1: 2400 WISTERIA DR
Address2: SUITE A
City: SNELLVILLE
State: GA
PostalCode: 300782689
CountryCode: US
TelephoneNumber: 7709820102
FaxNumber: 7709820130
Practice Location
Address1: 1800 TREE LN
Address2: SUITE 140
City: SNELLVILLE
State: GA
PostalCode: 300782016
CountryCode: US
TelephoneNumber: 7709821260
FaxNumber: 7709821262
Other Information
ProviderEnumerationDate: 03/10/2014
LastUpdateDate: 01/22/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT011396GAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


Home