Provider Demographics
NPI:1598401846
Name:RITZ, SAMANTHA DAWN (DPT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DAWN
Last Name:RITZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:SAM
Other - Middle Name:
Other - Last Name:RITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1200 CORPORATE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5424
Mailing Address - Country:US
Mailing Address - Phone:423-541-5492
Mailing Address - Fax:
Practice Address - Street 1:611 W BROWN ST STE 101
Practice Address - Street 2:
Practice Address - City:WYLIE
Practice Address - State:TX
Practice Address - Zip Code:75098-5816
Practice Address - Country:US
Practice Address - Phone:972-442-5287
Practice Address - Fax:972-442-3181
Is Sole Proprietor?:No
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1360023225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist