Provider Demographics
NPI:1396532172
Name:RITZ, KENNETH
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:RITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 RYAN ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-5536
Mailing Address - Country:US
Mailing Address - Phone:989-709-0625
Mailing Address - Fax:
Practice Address - Street 1:1908 W YOUNGS DITCH RD
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-6969
Practice Address - Country:US
Practice Address - Phone:989-893-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician