Provider Demographics
NPI:1740531243
Name:RITCHEY, ROY D (DC)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:D
Last Name:RITCHEY
Suffix:
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 1:95 TIMBER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8179
Mailing Address - Country:US
Mailing Address - Phone:636-357-5377
Mailing Address - Fax:
Practice Address - Street 1:1278 BRYAN RD
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-3771
Practice Address - Country:US
Practice Address - Phone:636-614-0401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-24
Last Update Date:2015-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012014017111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor