Provider Demographics
NPI:1922489079
Name:RITTENHOUSE, LONI (OD)
Entity Type:Individual
Prefix:DR
First Name:LONI
Middle Name:
Last Name:RITTENHOUSE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:LONI
Other - Middle Name:
Other - Last Name:DICKERHOOF
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:1195 GLENNVIEW ST NE
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44721-1912
Mailing Address - Country:US
Mailing Address - Phone:330-312-0497
Mailing Address - Fax:
Practice Address - Street 1:837 N COURT ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1718
Practice Address - Country:US
Practice Address - Phone:330-725-4464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6365152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist