Provider Demographics
NPI:1508098070
Name:RITTERSDORF, RUTH (BS)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:RITTERSDORF
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 141
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49501-0141
Mailing Address - Country:US
Mailing Address - Phone:616-248-5125
Mailing Address - Fax:616-243-2302
Practice Address - Street 1:781 36TH STREET SW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-0141
Practice Address - Country:US
Practice Address - Phone:616-248-5125
Practice Address - Fax:616-243-2302
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator