Provider Demographics
NPI:1811388861
Name:RITZ, TRAVIS JOHN (DC)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:JOHN
Last Name:RITZ
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 1:220 PLYMOUTH ST SW
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-3441
Mailing Address - Country:US
Mailing Address - Phone:712-546-4004
Mailing Address - Fax:
Practice Address - Street 1:220 PLYMOUTH ST SW
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3441
Practice Address - Country:US
Practice Address - Phone:712-546-4004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA076996111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor