Provider Demographics
NPI:1073681243
Name:RITTENBERRY, NORMAN WAYNE (DC)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:WAYNE
Last Name:RITTENBERRY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 HUMMINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-3110
Mailing Address - Country:US
Mailing Address - Phone:972-228-3095
Mailing Address - Fax:972-228-3096
Practice Address - Street 1:101 S LYNDALYN AVE
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-5709
Practice Address - Country:US
Practice Address - Phone:972-228-3095
Practice Address - Fax:972-228-3096
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6755111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor