Individual
KATHY RITTER GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
8051 VESTA AVE STE 2, NORTHFIELD, OH 44067-2081
(330) 468-0585
Mailing address
PO BOX 207170, DALLAS, TX 75320-7173
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4383/T289
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000208884
WORKER'S COMP
—
01
—
0161090001
MEDICARE SUPPLY PIN
—
01
—
0810886
AETNA HMO
—
01
—
5740054
AETNA PPO/POS
—
01
—
P00203851
MEDICARE/PALMETTO
—
01
—
R04383
SUMMA
—
Enumeration date
06/28/2006
Last updated
06/08/2021
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