Provider Demographics
NPI:1508953175
Name:WAYNE RITCHIE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:WAYNE RITCHIE PHYSICAL THERAPY LLC
Other - Org Name:PHYSICAL THERAPY AND REHABILITATION SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:RITCHIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSPT
Authorized Official - Phone:203-856-9876
Mailing Address - Street 1:168 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-6850
Mailing Address - Country:US
Mailing Address - Phone:203-856-9876
Mailing Address - Fax:
Practice Address - Street 1:168 YALE AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-6850
Practice Address - Country:US
Practice Address - Phone:203-856-9876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty