Provider Demographics
NPI:1275694838
Name:DR TORI RITCHIE PC
Entity Type:Organization
Organization Name:DR TORI RITCHIE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TORI
Authorized Official - Middle Name:
Authorized Official - Last Name:RADVANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:843-236-9810
Mailing Address - Street 1:3448 FORESTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29588-7931
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3448 FORESTBROOK RD
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-7931
Practice Address - Country:US
Practice Address - Phone:843-236-9810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2550111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1922077676OtherTYPE 1 INDIVIDUAL NPI
SCCH2550Medicaid
1275694838OtherTYPE 2 GROUP NPI
SC8240Medicare PIN