Individual
TRACI RIDDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
227 S COUNTY ROAD 21, MARIENTHAL, KS 67863-6302
(785) 272-1535
Mailing address
227 S COUNTY ROAD 21, MARIENTHAL, KS 67863-6302
(785) 272-1535
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1701259
KS
Other
Enumeration date
07/30/2009
Last updated
07/30/2009
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