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General NPI Number Information
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NPI Number | 1972978278
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Entity Type | Individual
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Provider Name | JUSTIN RATLIFF OTR
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Gender | Male
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Dates
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Enumeration Date | 12/11/2015
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Last Update Date | 12/11/2015
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Provider Practice Location Address
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Address Line | 6860 DALLAS PKWY STE 550
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City | PLANO
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State | TX
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Zip | 75024-4252
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Country | US
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Telephone | 877-899-5188
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Fax |
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Provider Business Mailing Address
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Address Line | 14 AVONLEA PARK DR
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City | PARIS
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State | KY
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Zip | 40361-1387
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | R3682
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License Number State | KY
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