Provider Demographics
NPI:1922077676
Name:RITCHIE, TORI ELAINE (PC)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:ELAINE
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:PC
Other - Prefix:DR
Other - First Name:TORI
Other - Middle Name:
Other - Last Name:RITCHIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PC
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:843-236-9810
Mailing Address - Fax:843-236-3702
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:843-236-3702
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2550111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCCH2550Medicaid
SCU836098240Medicare ID - Type Unspecified