Provider Demographics
NPI:1982636221
Name:RITCHIE, WILLIAM NELSON III (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:NELSON
Last Name:RITCHIE
Suffix:III
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 1:192 FAIRVIEW ROAD
Mailing Address - Street 2:PO BOX 70
Mailing Address - City:WOODLYN
Mailing Address - State:PA
Mailing Address - Zip Code:19094-1705
Mailing Address - Country:US
Mailing Address - Phone:610-833-2580
Mailing Address - Fax:610-833-5199
Practice Address - Street 1:192 FAIRVIEW ROAD
Practice Address - Street 2:
Practice Address - City:WOODLYN
Practice Address - State:PA
Practice Address - Zip Code:19094-1705
Practice Address - Country:US
Practice Address - Phone:610-833-2580
Practice Address - Fax:610-833-5199
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004057L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
0211216000OtherINDEPENDENCE BLUE CROSS