# WELLWAY MEDICAL PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396423547
- **Authorized official:** DR. SUSAN RITTER MD (OWNER/MEDICAL DOCTOR)
- **Authorized official phone:** (303) 229-8345

## Contact information

- **Practice address:** 2551 NORTERRE CIR, LIBERTY, MO 64068-3412
- **Practice address phone:** (816) 463-8930
- **Mailing address:** 2905 NORTHWEST BLVD STE 230, PLYMOUTH, MN 55441-2644
- **Mailing address phone:** (612) 367-4824

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/07/2023
- **Last updated:** 07/07/2023