Individual
MRS. LIESA MARIE RITCHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
18522 E PERSIMMON LN, OWASSO, OK 74055-8338
(918) 812-3932
Mailing address
18522 E PERSIMMON LN, OWASSO, OK 74055-8338
(918) 812-3932
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3646
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200030100A
EPSDT
OK
05
—
200030100B
—
OK
Enumeration date
07/15/2006
Last updated
11/04/2020
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