Provider Demographics
NPI:1376072967
Name:RITTER, CARLY (PT, DPT, OCS)
Entity type:Individual
Prefix:DR
First Name:CARLY
Middle Name:
Last Name:RITTER
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:811 SPECKLED TEAL PATH
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-6357
Mailing Address - Country:US
Mailing Address - Phone:765-398-4030
Mailing Address - Fax:
Practice Address - Street 1:550 SILVER BLUFF RD STE 600-700
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-6021
Practice Address - Country:US
Practice Address - Phone:803-220-3655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05012453A225100000X
SC125842251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist