| Mrs Samantha Ritter, DPT | |
|
125 N Cedar St, Waterman, IL 60556 | |
| (815) 264-8600 | |
| Not Available |
| Full Name | Mrs Samantha Ritter |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 125 N Cedar St, Waterman, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356940936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 070.023954 (Illinois) | Primary |
| Provider Name | Wylde Physical Therapy Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1740406123 PECOS PAC ID: 0941257760 Enrollment ID: O20050405000050 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Samantha Ritter, DPT 512 W Cherokee Ave, Shabbona, IL 60550-9774 Ph: (815) 993-1464 | Mrs Samantha Ritter, DPT 125 N Cedar St, Waterman, IL 60556 Ph: (815) 264-8600 |
Miss Maria Wanda Olson, PT SCS Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 125 N Cedar St, Waterman, IL 60556 Phone: 815-264-8600 Fax: 815-264-8644 | |
Dr. Alex Holliday, D.P.T Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 125 N. Cedar St., Waterman, IL 60556 Phone: 815-264-8600 | |
Michele Wylde, PT, ATC Physical Therapist Medicare: Medicare Enrolled Practice Location: 320 W Adams St, Waterman, IL 60556 Phone: 815-264-8600 Fax: 331-431-5462 |