Provider Demographics
NPI:1972021798
Name:RITCHIE, SAMANTHA JULIANNA (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:JULIANNA
Last Name:RITCHIE
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14655 TRIPLE CROWN LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-2508
Mailing Address - Country:US
Mailing Address - Phone:210-464-6373
Mailing Address - Fax:
Practice Address - Street 1:6500 INGRAM RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-3932
Practice Address - Country:US
Practice Address - Phone:210-397-7044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program