Provider Demographics
NPI:1881889236
Name:RITCHIE, MARK ALAN (DC)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:ALAN
Last Name:RITCHIE
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:PO BOX 1729
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-1729
Mailing Address - Country:US
Mailing Address - Phone:817-821-0137
Mailing Address - Fax:817-479-9720
Practice Address - Street 1:5583 DAVIS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6495
Practice Address - Country:US
Practice Address - Phone:817-821-0137
Practice Address - Fax:817-479-9720
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5998111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation