Provider Demographics
NPI:1184883480
Name:RITZLER, MINDY A
Entity type:Individual
Prefix:
First Name:MINDY
Middle Name:A
Last Name:RITZLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 52
Mailing Address - Street 2:
Mailing Address - City:NEW MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44442-0052
Mailing Address - Country:US
Mailing Address - Phone:330-501-0241
Mailing Address - Fax:
Practice Address - Street 1:4026 E CALLA RD
Practice Address - Street 2:
Practice Address - City:NEW MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:44442-0052
Practice Address - Country:US
Practice Address - Phone:330-501-0241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2706647Medicaid